Payor Intelligence Sr. Analyst

Role overview A healthcare technology company is building out a zero-to-one payor intelligence function to support its patient-access platform. The Senior Analyst will own the end-to-end mapping of how U.S. payors relate to one another, turning fragmented industry data into durable, product-ready logic. This is a high-ownership role for someone with deep institutional expertise who can drive decisions independently and partner across engineering, clinical, and operations.

Responsibilities - Build and maintain payor entity mapping, including hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships that govern coverage and authorization. - Source, interpret, and version medical policies, coverage criteria, government guidance, and fee schedules with clear provenance and effective dating. - Design the delegated-relationship logic that determines which entity owns a prior authorization decision for any given plan, product, or service. - Track clinical content dependencies such as InterQual and NCCN, identifying contract needs and renewal timing. - Reconcile prospect and customer payor data against the internal payor model, converting recurring manual work into a repeatable system. - Operate with a founder mindset, driving ambiguous projects from concept to completion with minimal handholding.

Requirements - 5+ years working broadly across the U.S. payor landscape, including Medicare, Medicare Advantage, Medicaid and MCOs, and commercial lines of business. - Deep fluency in payor structure: parent organizations, subsidiaries, regional versus national plans, self-funded versus fully insured arrangements, and delegated entities. - Demonstrated ability to research and reconcile payor policies, fee schedules, and clinical guidelines, including resolving conflicting sources. - A track record of building taxonomies, frameworks, databases, or mapping systems that other teams rely on. - Strong analytical and pattern-recognition skills with the instinct to work productively from incomplete information. - Excellent communication skills, able to explain complex payor concepts to technical and non-technical audiences alike.

Nice to have - Familiarity with SQL or comparable data tooling.

Benefits and work setup - Remote flexibility with quarterly in-person collaboration at a Hudson Square office. - Unlimited paid time off. - 100% employer-paid employee health benefit options. - Employer-funded 401(k) match. - Competitive parental leave.