Manager - Medical Policy Business Analytics
Core
Manage analytics, reporting, performance measurement, and operational intelligence to support Medical Policy and Payment Integrity functions, translating healthcare data into actionable insights.
Role type
Manager, Medical Policy Business Analytics
Builds
Dashboards, scorecards, KPIs, and performance reporting solutions for leadership and business partners.
Domain
Healthcare / Medical Policy / Payment Integrity / Business Intelligence
Deliverable
dashboards & analysis
Required skills
Healthcare analytics, Business Intelligence, Medical Policy, Payment Integrity, Root cause analysis, Executive dashboard development, Trend analysis, Forecasting, Stakeholder management, Microsoft Excel, Power BI, Tableau, SQL, SAS, Snowflake, Azure Analytics
Preferred skills
Medical/policy configuration, Claims editing, Adjudication workflows, Enterprise governance, BRD development, Predictive analytics, Machine learning, Statistical modeling
Responsibilities
Develop and maintain performance reporting and scorecards; Oversee design and automation of BI tools; Monitor policy adherence and compliance; Conduct root cause analyses for operational inefficiencies; Partner with stakeholders to gather reporting requirements; Coordinate cross-functional analytical initiatives.
Seniority
Manager, hands-on leadership
