Senior Business Analytics Manager – Payment Integrity, Risk & Affordability
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Business Analytics Senior Manager overseeing analytics for healthcare cost management initiatives with a focus on AI and financial performance. Leading a team to drive insights for improved affordability.
Responsibilities:
- Lead strategic analytics by identifying medical cost drivers and trends, risks, and affordability opportunities.
- Develop and execute analysis and AI to support Payment Integrity strategies at the enterprise level driving alignment across various business unites to ensure enterprise financial goals & priorities
- Tell the story behind the data, translating analytical findings into clear, executive‑ready insights that influence decisions across technical, operational, and senior leadership audiences.
- Own financial business cases for new affordability initiatives, including forecasts, variance analysis, and recommendations to improve performance.
- Support Payment Integrity by overseeing analytics for initiatives, policy changes, and ongoing performance monitoring.
- Improve reporting and visualization by assessing current capabilities and advancing self‑service analytics solutions, utilizing AI to optimize quality, accuracy and reporting (e.g., Databricks, Tableau, Claude, Cursor or similar tools).
- Modernize analytics through scalable methods, automation, and thoughtful use of AI‑enabled tools where they add value.
- Monitors and conducts research of related affordability, AI, business trends, using data and qualitative performance measures, to advise senior management relative to Payment Integrity strategy.
- Manage and develop a team of analysts, setting clear priorities, ensuring high‑quality output, and supporting continuous skill development.
- Balance multiple initiatives by prioritizing and delegating work effectively in a fast‑paced, dynamic environment.
- Ensure data quality and accuracy by implementing appropriate checks, controls, and processes.
- Act as a trusted thought partner to senior leaders by proactively identifying insights, risks, and emerging trends that inform near‑ and long‑term affordability strategy.
Requirements:
- Bachelor’s degree or equivalent in a quantitative field such as Economics, Finance, Data Science or Analytics, Business, Applied Mathematics, Public Health, Actuarial Science or similar.
- Master’s degree preferred
- 7+ years of progressive experience in predictive analytics, financial modeling, healthcare economics, or related fields, including experience leading or mentoring analysts
- Strong analytical and technical skills, with hands‑on experience using tools such as SQL, Excel, SAS, Databricks, Tableau, or similar platforms
- Experience with and knowledge of medical claim coding, and provider reimbursement.
Benefits:
- medical, vision, dental, and well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- minimum of 18 days of paid time off per year
- paid holidays
Similar Jobs
Senior Group Risk Specialist – Consumer Digital Risk
Senior Group Risk Specialist providing diverse risk management expertise for Consumer Deposit and Payments Program at TD. Leading implementation of risk frameworks and engaging stakeholders for effective risk mitigation.
Data Risk Analyst
Clinical Data Risk Analyst identifying and mitigating risks in clinical trial data, ensuring compliance and data integrity. Collaborating with teams and utilizing statistical tools to support clinical programs.
Business Analytics Advisor – Payment Integrity, Risk & Affordability
Business Analytics Advisor leading analytics on medical cost savings initiatives for Cigna. Collaborating cross-functionally to develop insights and strategies for cost management.
Program Risk Analyst
Program Risk Analyst supporting risk management for major infrastructure programs at AECOM. Collaborating on risk mitigation and ensuring program effectiveness within Construction Management.
Senior Analyst, Analytics Development – Model Governance
Senior Analyst supporting fraud analytics by developing and optimizing machine learning models at Experian. Collaborating on data insights to drive fraud prevention and governance initiatives.
Analyst, Travel Risk Management
Travel Risk Management Analyst supporting the delivery of TRM services and consulting engagements. Collaborating with various teams to align crisis response and risk management.
Data Governance Analyst – Mid
Data Governance Analyst supporting data governance initiatives alongside client Data Teams. Focusing on data quality, cataloging, management, and governance processes.
Risk Officer
Risk Officer responsible for leading risk management framework for El Salvador crypto-payments operation. Engaging with Salvadoran regulatory bodies and maintaining risk compliance standards.
Speech Therapy Practice Owner
Logopäd:in providing logopädische Therapien in einem modernen Team. Flexible Arbeitszeiten und Spezialisierungsmöglichkeiten in einer risikofreien Praxis.
Senior Data Governance Architect – Azure, Databricks
Senior Data Governance Architect role focused on enterprise data governance in Azure and Databricks environments. Collaborating with technical and business teams to establish robust governance practices.
Risk Advisor – Commercial Lines
Risk Advisor responsible for new insurance account production in the insurance market. Engaging in consultative sales to clients and expanding service lines for existing accounts.
Risk Advisor – Employee Benefits
Risk Advisor responsible for insurance account production and sales activities at Relation Insurance. Achieving revenue targets through consultative sales and client relationship management.
Revenue Management Risk Analyst
Revenue Management Risk Analyst managing risk across group accounts in revenue operations. Overseeing billing risk, assessing financial exposure, and driving process improvements.
VP, Product – Data Governance
Vice President of Product leading enterprise data governance strategy at Walker & Dunlop. Overseeing governance capabilities and collaborating with various teams to operationalize data management practices.
Junior Governance Analyst, Advanced Spanish
Analista de Governança Junior responsável por solucionar problemas de TI e comunicar incidentes críticos. Atuando na gestão de CAPEX, OPEX e auditorias de TI.
Director, Market Risk Control
Director of Market Risk Control at esVolta leading risk management in the renewable energy market. Building frameworks, analyzing risks, and ensuring compliance with trading activities.
Director, Digital Governance
Director of Digital Governance at Sarah Cannon Research Institute focusing on IT, data, and AI governance frameworks. Ensuring compliance and quality assurance in regulated technology environments with a high level of experience required.
Senior Global Trade Analytics, Governance CoE Manager
Manager of Global Trade Analytics at Deckers Brands shaping data-driven operations and governance. Leading analytics strategy and fostering data excellence across teams in a dynamic environment.
Risk Control Consultant
Risk Control Consultant performing workplace risk evaluation and consulting for CNA. Focused on enhancing risk control programs and providing training to partners.
Commercial Risk Manager – EPC, Contracts
Global Risk Manager driving strategic direction and compliance at Canadian Solar. Overseeing e-Storage risk processes and supporting sales teams for contract negotiations.