Senior Manager, Claims Analytics

Rialtic; Hyderabad; Vor Ort; INR 2.500.000 - 4.000.000; Vollzeit

Zusammenfassung

Rialtic in Hyderabad, India seeks a Senior Manager, Claims Analytics to lead the analytics function within Implementation. You will scale analytical rigor, lead high‑impact client work, and develop a team delivering clear, defensible insights driving financial outcomes.

This role blends healthcare claims expertise with people leadership and cross‑functional collaboration, balancing strategic and hands‑on work to set direction, review analyses, and partner with clients and stakeholders.

Qualifikationen

• 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.
• Prior experience with claims editing or payment accuracy vendors.
• Deep knowledge of medical coding, billing guidelines, and reimbursement methodologies.
• Proven people leadership experience managing and developing analytics teams.
• Advanced proficiency in SQL and experience working with large healthcare datasets.
• Strong executive communication and presentation skills.

Aufgaben

• Lead and mentor a team of Implementation Claims Analysts; define analytical methodologies and reporting frameworks.
• Partner with Implementation leadership to align analytics deliverables with client goals and timelines.
• Act as a subject-matter expert in claims analytics for complex client implementations.
• Oversee large-scale analysis of claims data related to payment accuracy, reimbursement, and revenue integrity.
• Ensure analytics outputs are actionable, defensible, and clearly distinguish systemic vs. isolated issues.
• Collaborate with GTM, Customer Success, Product, and Engineering to influence roadmaps based on insights.

Kenntnisse

Analytical leadership

Executive communication

Stakeholder management

Cross-functional collaboration

Strategic thinking

Tools

SQL*Loader

Oracle

Shell scripting

Python

PL/SQL

Scala

Spark

AWS

Jobbeschreibung

Job Description: Senior Manager, Claims Analytics

Role: Senior Manager, Claims Analytics

Team: Implementation, GTM

Reports To: VP of Implementation, Cliff Walker

Role Overview

The Senior Manager, Claims Analytics, leads the claims analytics function within the Implementation organization. This role is responsible for overseeing complex reimbursement and payment accuracy analyses, managing analysts, setting analytical standards, and partnering cross-functionally with GTM, Customer Success, Product, and Engineering teams to ensure successful client implementations.

This role combines deep healthcare claims expertise with people leadership, strategic thinking, and operational execution to scale analytics capabilities and drive measurable financial outcomes for clients.

Key Responsibilities

• Lead and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans. Define and standardize analytical methodologies, reporting frameworks, and best practices for claims and reimbursement analysis.
• Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and success metrics.
• Act as a subject-matter expert in claims analytics for complex or high-visibility client implementations.

Analytics & Execution

• Oversee large-scale analysis of claims data related to charge capture, reimbursement, underpayment, overpayment, and payment accuracy.
• Ensure the delivery of exception-driven, actionable insights that clearly identify systemic versus isolated issues.
• Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in reporting and client-facing deliverables.
• Guide analyses related to:
  • Payor reimbursement behavior and trends
  • RVU productivity and payment alignment
  • Revenue cycle optimization opportunities
  • Financial performance to benchmarks, goals, and norms

Cross-Functional Collaboration

• Partner with GTM and Customer Success teams to support implementations, renewals, and expansion opportunities through analytics insights.
• Collaborate with Product and Engineering teams to influence roadmap priorities based on claims analysis findings and client needs.
• Serve as a senior analytics representative in client-facing discussions, executive readouts, and strategic reviews.

Technical Oversight

• Provide guidance on data ingestion and processing pipelines using SQL*Loader, Oracle, shell scripting, and cloud-based tools.
• Oversee advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and AWS.
• Ensure scalable, repeatable approaches to analyzing billions of claims records across clients.

Required Qualifications

• 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.
• Prior experience working with claims editing or payment accuracy vendors.
• Strong expertise in medical coding, billing guidelines, and reimbursement methodologies.
• Proven people leadership experience managing and developing analytics teams.
• Advanced proficiency in SQL and experience working with large healthcare datasets.
• Strong executive communication and presentation skills.

Core Competencies

• Strategic thinking with a strong bias toward execution
• Ability to lead through ambiguity and change
• High accountability and ownership mindset
• Strong client-facing presence and stakeholder management skills
• Passion for building scalable analytics capabilities and high-performing teams

Role: Senior Manager, Claims Analytics

Team: Implementation

Reports To: VP of Implementation

About the Role

The Senior Manager, Claims Analytics, leads Rialtic’s claims analytics function within Implementation. This role is responsible for scaling analytical rigor, leading high-impact client work, and developing a team that consistently delivers clear, defensible, and outcome-driven insights.

You will combine deep healthcare reimbursement expertise with strong people leadership and cross-functional collaboration. This role is both strategic and hands‑on: setting direction, reviewing complex analyses, and serving as a trusted analytics partner for clients and internal stakeholders.

What You’ll Do

Lead & Scale the Function

• Establish analytical standards, methodologies, and best practices across implementations.
• Set priorities and ensure on‑time, high‑quality delivery of analytics work across multiple
• Act as a senior subject‑matter expert for complex or high‑visibility implementations.

Drive Analytics That Matter

• Oversee large-scale analysis of claims data related to payment accuracy, charge capture, reimbursement, and revenue integrity.
• Ensure analytics outputs are exception‑driven, actionable, and defensible, clearly separating systemic issues from isolated findings.
• Review and validate complex analyses and client‑facing deliverables for accuracy, clarity, and impact.
• Guide analytical work focused on:
  • Payor reimbursement behavior and contract performance
  • Underpayment and overpayment trends
  • RVU productivity relative to payment outcomes
  • Revenue cycle and billing optimization opportunities
• Collaborate closely with GTM and Customer Success to support implementations, renewals, and expansion opportunities.
• Partner with Product and Engineering teams to inform roadmap priorities based on real‑world claims insights.
• Serve as a senior analytics voice in client discussions, executive readouts, and strategic reviews.

Technical & Analytical Oversight

• Provide direction on data ingestion and processing using SQL*Loader, Oracle, and shell scripting.
• Guide advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and AWS.
• Ensure scalable, repeatable approaches to analyzing billions of claims records across clients.

What We’re Looking For

• 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.
• Prior experience with claims editing or payment accuracy vendors.
• Deep knowledge of medical coding, billing guidelines, and reimbursement methodologies.
• Proven experience leading and developing analytics teams.
• Advanced SQL expertise and experience working with large healthcare datasets.
• Strong executive-level communication and client-facing skills.

What Makes You Successful at Rialtic

• Comfortable owning outcomes, not just analysis
• Able to lead through ambiguity and evolving requirements
• Strong judgment in balancing speed, rigor, and practicality
• Trusted partner to clients and internal stakeholders
• Passion for building scalable analytics and high‑performing teams

About the Role

The Senior Claims Analytics Lead is a senior individual contributor within Rialtic’s Implementation organization, responsible for delivering rigorous, defensible claims analytics that drive measurable financial outcomes for clients.

This role is hands‑on and highly analytical. You will independently lead complex claims analyses, translate large-scale healthcare data into actionable insights, and serve as a trusted subject‑matter expert during client implementations. You will partner closely with Implementation leadership, GTM, Customer Success, Product, and Engineering while maintaining end‑to‑end ownership of analytical quality and outcomes.

What Is Required

• 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis
• Prior experience with claims editing or payment accuracy vendors
• Deep knowledge of medical coding, billing guidelines, and reimbursement methodologies
• Advanced proficiency in SQL and experience analyzing large healthcare datasetsStrong hands‑on analytical skills with the ability to independently own complex analyses
• Experience producing clear, client‑ready insights and executive-level readouts
• Comfort working cross‑functionally and operating in ambiguous, fast-moving