About The Position

The Payment Integrity and Affordability Governance organization delivers innovative, analytics‑driven solutions that reduce healthcare costs, improve outcomes, strengthen financial security, and support data‑informed decision‑making across the enterprise. Within this organization, the National Affordability Initiatives Team leads measurement and analytics for national ancillary and utilization management (UM) programs. This role supports the aggregation, analysis, and reporting of program results and the development of scalable data tools that enable timely, actionable insights for internal and external partners. The position focuses on vendor‑delegated utilization management programs , helping stakeholders understand performance, cost trends, and opportunities to improve affordability and competitiveness.

Requirements

  • 4+ years of experience in financial analysis, planning, or modeling, with demonstrated ability to analyze data at both macro and micro levels.
  • Proficiency in Excel and SQL
  • Strong analytical and problem‑solving skills with high attention to detail.
  • Solid understanding of analytical systems, processes, and methodologies.
  • Strong verbal and written communication skills, with the ability to summarize and present insights to diverse stakeholders.
  • Proven ability to prioritize and manage multiple initiatives simultaneously.
  • Self‑starter with a demonstrated commitment to continuous learning and technical growth.
  • If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

  • Experience with SAS, Databricks, and/or Tableau
  • Knowledge of healthcare analytics, including claims and authorization data.
  • Familiarity with provider reimbursement, fee schedules, and contract modeling, or the ability to learn quickly.
  • Experience supporting utilization management, affordability, or payment integrity initiatives in a healthcare or payer environment

Responsibilities

  • Monitor and analyze performance of national utilization management and ancillary programs, identifying trends, risks, and opportunities.
  • Perform impact analysis to assess the effect of utilization management programs on claims and cost trends.
  • Integrate and analyze data from multiple sources to identify root causes, variances, and improvement opportunities.
  • Develop and automate reporting and analytics that improve transparency and decision‑making.
  • Build forward‑looking financial models to support business cases for proposed affordability initiatives.
  • Support national provider contract negotiations through performance monitoring, trend analysis, and financial insights.
  • Develop targets and strategies that enhance competitiveness and support national affordability objectives.
  • Communicate performance results, insights, and affordability opportunities to partners across National Ancillary, Clinical, Product, Local Markets, and Risk & Affordability Outcomes.
  • Translate complex analytical findings into clear, actionable insights for both technical and non‑technical audiences.
  • Collaborate with matrix partners to improve operational efficiency, mitigate risk, and drive aligned outcomes.
  • Apply critical thinking to streamline analytical processes and optimize outcomes.
  • Effectively manage multiple workstreams in a fast‑paced, dynamic environment.
  • Demonstrate a continuous improvement mindset and a commitment to developing subject matter expertise in national affordability and industry levers impacting results.

Benefits

  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

No Education Listed

Number of Employees

5,001-10,000 employees

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