Senior Medical Cost Analytics Advisor (Remote)
Core
Provide strategic and analytical support to the Payment Integrity team by evaluating pre- and post-payment programs, clinical coding audits, and recovery initiatives to identify opportunities for savings and improved performance.
Role type
Senior Medical Cost Analytics Advisor
Builds
Actionable insights, business cases, forecasts, variance analysis, and dashboards for enterprise affordability goals.
Domain
Healthcare / Medical Cost Analytics / Payment Integrity
Deliverable
dashboards & analysis
Required skills
Medical cost analytics, financial modeling, reimbursement methodologies (MS-DRG, APCs, HCPCs, RBRVS), SQL, Excel, SAS, Tableau, Databricks, predictive modeling, NLP, machine learning
Preferred skills
AI-enabled tools, automation, data quality improvement
Responsibilities
Identify trends, risks, and affordability opportunities across cost containment programs; translate complex data findings into executive-ready insights; own financial impact assessments and business cases; support program measurement and performance monitoring; identify and size new opportunities by assessing billing patterns; partner across the enterprise to align insights to decisions; advance reporting and analytics through automation and AI-enabled tools.
Seniority
Senior, hands-on IC
