Healthcare Payment Integrity Data Analytics Lead

PacificSource Health Plans

Portland (OR)

On-site

USD 57,000 - 97,000

Full time

8 days ago

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Job summary

PacificSource Health Plans is seeking an Analytics Specialist to drive data analysis, reporting, and performance monitoring for payment integrity initiatives. You will build dashboards, analyze claims and reimbursement data, and support FWA prevention with cross-functional collaboration across Finance, Compliance, IT, and vendor teams.

The role emphasizes identifying opportunities, tracking recoveries and cost avoidance, and delivering recurring financial and operational reports to leadership

Qualifications

Healthcare analytics, claims analytics, payment integrity, or related experience.
Experience with budgeting, forecasting, or performance measurement is plus.
Knowledge of healthcare reimbursement methodologies and data reporting.

Responsibilities

Develop, maintain, and distribute payment integrity dashboards and scorecards.
Analyze claims, provider data, and reimbursements to identify opportunities.
Support fraud, waste, and abuse analysis through data reporting.
Validate recoveries, savings, and vendor performance metrics.
Create ad hoc analyses and leadership-ready presentations.
Collaborate with IT and data teams to improve reporting capabilities.

Education

Bachelor's degree in business/finance/statistics/data analytics/healthcare administration/information systems

High school diploma or equivalent

Tools

SQL

Power BI

Tableau

Excel

Job description

The role emphasizes identifying opportunities, tracking recoveries and cost avoidance, and delivering recurring financial and operational reports to leadership

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