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Responsibilities:
- Serve as the primary operational subject matter expert for payment integrity methodologies and product requirements.
- Translate payer pain points, contract language, and audit policy into scalable product capabilities.
- Partner with engineering to define, develop, and build high-performing AI solutions.
Qualifications:
- 5–10+ years progressive experience in Payment Integrity, healthcare audit, or clinical operations.
- Deep knowledge of U.S. healthcare payer payment integrity programs and vendor management.
- Strong analytical skills with comfort using hit-rate analysis and ROI modeling.
What We Offer:
- Competitive leave and benefits package.
- Equity for every employee to share in success.
- Growth-focused environment supporting your development.
Abacus Insights
Abacus Insights transforms healthcare data for health plans, breaking down silos to create trusted data foundations that improve outcomes and reduce waste. Backed by $100M from top investors, the company has a bold, collaborative culture focused on innovation and using AI to drive efficiency.