Business Analyst, Clinical & Reimbursement Policy

📋 Description

• Own lifecycle of clinical and reimbursement policies
• Interpret Medicare rules into actionable logic
• Coordinate with teams to reflect policy in claims systems
• Manage external vendor relationships and improvements
• Lead AI-driven policy monitoring and research
• Research industry/regulatory trends and risks

🎯 Requirements

• 5+ years in healthcare claims, policy, or related ops
• Medicare Advantage expertise; Medicare regs knowledge
• Translate regulatory requirements into operational workflows
• Experience with AI/LLM tools for research/automation
• Vendor management and performance evaluation
• Familiarity with enterprise claims engines and adjudication

🎁 Benefits

• Competitive base salary: $107,000–$130,000 USD
• Equity, bonus eligibility, 401(k) matching
• Medical, dental, vision coverage
• Flexible time-off and holidays
• Remote-first with collaboration flexibility
• No-Meeting Fridays