Senior Payor Intelligence Analyst
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Job Description
Payor intelligence analyst mapping U.S. insurance entities, policies, and authorization logic. Building data systems for Tennr’s healthcare paperwork automation platform.
Responsibilities:
- Build and own payor entity mapping, including hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships
- Source, interpret, and govern medical policies, coverage criteria, government guidance, and fee schedules
- Establish effective dating, provenance, and version control for policy information
- Design delegated-relationship logic behind prior authorization
- Determine which entity owns the decision for a given plan, product, and service
- Identify and track clinical content sources such as InterQual and NCCN
- Own contracting requirements and timing for clinical content sources
- Map prospect and customer payor data to Tennr's payor model
- Turn recurring manual work into a repeatable system
- Drive projects from conception to completion
- Contribute to company growth and success
- Collaborate with engineering, clinical, and operations teams
- Collaborate and connect with colleagues in the Hudson Square office, with quarterly office travel
Requirements:
- 5+ years working across the U.S. payor landscape
- Breadth across Medicare, Medicare Advantage, Medicaid and MCOs, and commercial lines of business
- Fluency in payor structure, including payor families, subsidiaries, TPAs, PBMs, delegated entities, regional versus national plans, and self-funded versus fully insured arrangements
- Experience researching and interpreting payor policies, government guidance, fee schedules, or clinical guidelines
- Experience reconciling sources that disagree with each other
- Track record of building taxonomies, frameworks, databases, or mapping systems
- Exceptional analytical and pattern-recognition skills
- Investigative instinct to work from ambiguous and incomplete information
- Self-directed ownership of a domain end to end
- Outstanding communication skills
- Familiarity with SQL or comparable data tooling is a plus
- Ability to work in the U.S. payor landscape
- Required application of work authorization or visa sponsorship status
Benefits:
- Equity
- Bonus
- Remote Flexibility
- Unlimited PTO
- 100% paid employee health benefit options
- Employer funded 401(k) match
- Competitive parental leave
- Travel to Hudson Square office on a quarterly basis
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