Healthcare Content Portfolio Analyst III

As a Healthcare Content Portfolio Analyst you’ll transform complex healthcare policy into intelligent, automated logic that powers Rialtic’s payment accuracy engine. Working at the intersection of clinical expertise, policy research, and SaaS development, you’ll create high-impact claims editing rules that help leading payers reduce overpayments and promote transparent, accurate reimbursement practices. You will interpret and translate complex CMS, AMA/CPT, and commercial payer policies into actionable claims editing logic. You will also own the development of precise, high-quality edit specifications in close partnership with Engineering to ensure seamless implementation. The role involves designing and executing robust unit tests to validate logic performance, accuracy, and alignment with source policy. Act as a subject matter expert across Medicaid, Medicare, and commercial lines—providing deep expertise in coding, billing, and reimbursement. Maintain and enhance existing content by proactively monitoring and applying regulatory and policy updates, analyzing performance data to confirm edit efficacy, and collaborating cross-functionally with Product and Engineering to improve tooling.