Senior Medical Cost Analytics Advisor (Remote)

Role overview Provide senior analytical support for medical cost and payment integrity initiatives. Evaluate program results, identify opportunities to reduce avoidable spending, and turn complex claims and financial data into clear recommendations, business cases, and materials for leaders.

Responsibilities - Analyze trends, risks, and savings opportunities across cost containment and payment integrity programs. - Build financial impact assessments and business cases, including forecasts, variance analysis, and performance recommendations. - Measure pre-payment and post-payment edits, coding audits, and recovery programs through dashboards, scorecards, and leadership reporting. - Examine billing patterns, coding, reimbursement, and potential sources of waste or abuse to identify new opportunities. - Work with finance, clinical, claims, compliance, network, product, and vendor partners to connect findings to decisions and execution. - Support vendor evaluation and sourcing, and improve data quality, controls, automation, and scalable self-service analytics.

Requirements - Bachelor’s degree in a quantitative or related field, or equivalent experience. - At least eight years of progressive experience in medical cost analytics, payment integrity, financial modeling, or a related area. - Hands-on analytical experience with tools such as SQL, Excel, SAS, Tableau, Databricks, or similar platforms. - Knowledge of reimbursement methods and coding, including examples such as MS-DRG, APC, HCPCS, or RBRVS, and familiarity with professional and facility claims. - Experience applying automation or advanced analytics, such as predictive modeling, natural language processing, or machine learning, where these methods deliver measurable value. - Ability to communicate complex findings to senior audiences and collaborate across teams in regulated, compliance-aware settings.

Benefits and work setup - Remote work requires cable broadband or fiber internet with at least 10 Mbps download and 5 Mbps upload. - Anticipated annual salary is $112,800–$188,000, depending on experience and location, with expected eligibility for an annual bonus plan. - Benefits include medical, dental, and vision coverage, wellbeing programs, a 401(k), paid holidays, and at least 18 days of paid time off per year.