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, Healthcare Business Analytics & Reporting
Builds
Executive dashboards, scorecards, KPIs, and performance reporting solutions
Domain
Healthcare / Medical Policy / Payment Integrity
Deliverable
dashboards & analysis
Required skills
Healthcare analytics, Business Intelligence, Medical Policy, Payment Integrity, Root cause analysis, Trend analysis, Forecasting, Stakeholder management, Data governance, Advanced Excel, Power BI, Tableau, SQL, SAS, Snowflake, Azure Analytics
Preferred skills
Claims editing, Adjudication workflows, Predictive analytics, Machine learning, Statistical modeling, BRD development, Process mapping, Audit readiness support
Technologies
Power BI, Tableau, SQL, SAS, Snowflake, Azure Analytics
Responsibilities
Develop and maintain performance reporting and scorecards for Medical Policy and Payment Integrity; Oversee design and automation of dashboards and analytical reporting solutions; Monitor policy adherence and compliance with regulatory requirements; Conduct root cause analyses to identify operational inefficiencies; Partner with stakeholders to gather business requirements and support strategic initiatives; Coordinate cross-functional workgroups and present insights to leadership.
Seniority
Manager, hands-on leadership
