Remote Senior Medical Cost Analytics Leader

Jobgether; USA; Remote; USD 113.000 - 188.000; Vollzeit

Zusammenfassung

Jobgether is partnering with a US-based organization to hire a Senior Medical Cost Analytics Advisor. The role focuses on data-driven financial analysis to advance healthcare affordability, focusing on pre/post-payment programs, coding audits, and recovery opportunities.

You will collaborate with Finance, Claims, Compliance, Network Analytics, and external vendors to drive enterprise-wide improvements and modernize reporting, including automation and AI-enabled analytics.

Qualifikationen

• Bachelor's degree or equivalent professional experience in a quantitative field.
• 8+ years in medical cost analytics, payment integrity, or related areas.
• Strong analytical and quantitative capabilities with healthcare cost data.
• Proficiency with SQL, Excel, SAS, Tableau, Databricks or similar tools.
• Knowledge of MS-DRG, APCs, HCPCS, RBRVS and reimbursement methods.
• Experience in regulated environments and communicating to leadership.

Aufgaben

• Drive medical cost analytics and identify cost-saving opportunities.
• Translate data into strategic insights for executives and technical teams.
• Develop financial impact analyses, forecasting, and business cases.
• Monitor program effectiveness with dashboards and scorecards.
• Identify cost recovery opportunities from billing and coding data.
• Collaborate across Finance, Claims, Compliance, Network, and Vendors.
• Support vendor evaluations, pricing models, and contracts.
• Improve reporting capabilities and data quality with scalable analytics.
• Promote automation and AI-enabled analytics to boost efficiency.
• Inform strategic planning and enterprise affordability priorities.
• Ensure compliance with healthcare regulations and audit requirements.
• Drive continuous improvement of analytics methodologies and workflows.

Kenntnisse

SQL

Microsoft Excel

SAS

Tableau

Databricks

Cost analytics

Financial modeling

Reimbursement methodologies

NLP

Machine learning

Executive communication

Stakeholder management

Ausbildung

Bachelor's degree in Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, or Applied Mathematics

Tools

SQL

Microsoft Excel

SAS

Tableau

Databricks

Jobbeschreibung

Jobgether is partnering with a US-based organization to hire a Senior Medical Cost Analytics Advisor. The role focuses on data-driven financial analysis to advance healthcare affordability, focusing on pre/post-payment programs, coding audits, and recovery opportunities.

You will collaborate with Finance, Claims, Compliance, Network Analytics, and external vendors to drive enterprise-wide improvements and modernize reporting, including automation and AI-enabled analytics.