Remote Payment Integrity & Analytics Lead

Rialtic; Georgia; Remote; USD 120,000 - 160,000; Full time

Benefits offered by this job

Equity

401(k) with company matching

Home office allowance

Job summary

Rialtic is seeking a highly analytical Payments Integrity Analytics & Strategy Manager to lead strategic editing initiatives through market intelligence, coding and reimbursement analysis, and data-driven content strategy. You will bridge data, policy, and product development across Commercial, Medicare, and Medicaid, shaping future edits and revenue protection programs.

You will collaborate with Content, Product, Clinical, Technology, and Client teams to drive development, prioritization, and

Qualifications

• 5+ years in healthcare analytics, payment integrity, clinical policy, or clinical editing.
• End-to-end experience supporting Commercial, Medicare, and Medicaid payment integrity programs.
• Proven ability to translate complex healthcare data into strategic recommendations.

Responsibilities

• Identify, evaluate, and prioritize new clinical editing opportunities through analysis of claims data and market intelligence.
• Develop data-driven recommendations for payment integrity initiatives.
• Monitor healthcare trends, coding updates, and regulatory changes to identify content/policy expansion opportunities.
• Build dashboards, reports, and executive summaries communicating findings to leadership and clients.

Skills

Advanced SQL

Healthcare analytics

Data visualization

Python

Education

Bachelor's degree or equivalent

Tools

SAS

Excel

Job description

Rialtic is seeking a highly analytical Payments Integrity Analytics & Strategy Manager to lead strategic editing initiatives through market intelligence, coding and reimbursement analysis, and data-driven content strategy. You will bridge data, policy, and product development across Commercial, Medicare, and Medicaid, shaping future edits and revenue protection programs.

You will collaborate with Content, Product, Clinical, Technology, and Client teams to drive development, prioritization, and