Be responsible for the monitoring and management of the end to end data flow of data submissions to vendors and government agencies to mitigate data leakage and submission errors.
Own the claim and supplemental submission workflow for CMS EDS submissions.
Develop data pipeline tracking reports and analyze, research, and resolve encounter data errors.
Support the development and maintenance of secure, scalable data systems that enable clinical, operational, and financial analytics in a HIPAA‑regulated environment.
Contribute to building and operating data pipelines that ingest, transform, and standardize data from internal and external healthcare sources such as EHRs, claims vendors, and SDOH APIs.
Work closely with analysts and business stakeholders to understand requirements and help create reliable, analytics‑ready datasets and basic data models.
Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with healthcare partners, including Kaiser Permanente. They aim to enable older adults to experience an independent and joyful aging journey, and are growing to support this mission.
Maintain internal CMS HCC and RxHCC models for calculating member level risk scores.
Support the monthly close process, including the development of actuarial risk adjusted revenue accruals and analysis of results.
Build reports to track ROI on various risk adjustment initiatives.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep their members healthier. They are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Contribute to software systems used by millions of low-income Americans
Drive change through impactful data analysis and investigations
Maintain reliable data pipelines to ensure trustworthy data
Propel builds technology that strengthens the social safety net. They are a passionate team of ~100 Propellers who envision a future where every American has the tools and resources they need to thrive, and is a for-profit, venture-backed company that holds its social mission at its core.
Interpret and apply CMS, Medicare, Medicaid, and AMA policies to define claims editing logic.
Analyze claims and edit performance data to confirm accuracy and prioritize enhancements.
Monitor regulatory updates and coding changes to keep edits current and compliant.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. They use an AI-powered platform with expertise across the payment continuum, serving over 85 health plans and 270 million lives.
Monitors for changes in existing business processes and updates documentation accordingly
Finds new opportunities for process developments and improvements
Drives root-cause-analysis and resolution of data and processes issues/errors by partnering with key stakeholders
Judi Health is an enterprise health technology company providing solutions for employers and health plans. They offer full-service pharmacy benefit management and health benefit management solutions on its proprietary Enterprise Health Platform.
Contribute to the technical integrity and evolution of the Data Platform tech stack.
Design and implement core features and enhancements within the Data Platform.
Build and maintain robust data extraction, loading, and transformation processes.
Dimagi is an award-winning social enterprise and certified B-corp building software solutions and providing technology consulting services to improve the quality of essential services for underserved populations. They are passionate and committed to tackling complex health and social inequities and working towards a brighter future for all.
Build Maven’s ability to drive sales through payer channels through strategic and analytic support to identify potential clients for all Maven programs and build a business case for them.
Lead end‑to‑end outcome evaluations for payer clients, designing robust methodologies and performing hands‑on analyses of medical and pharmacy claims, eligibility files and Maven platform data.
Own technical and clinical relationships with payer stakeholders, serving as their primary point of contact for study design, data sharing, results interpretation and ongoing analytic support.
Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs.
Work hands-on and obtain a deep understanding of healthcare data.
Lead analytics efforts and deliver technical products with measurable impact.
Apply an analytical, first principles approach to problem-solving and data-driven decision-making.
Machinify is a healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They deploy an AI-powered platform and expertise to maximize financial outcomes and drive down healthcare costs, serving over 85 health plans and 270 million lives.
Work with Data Exchange partners and internal teams to maintain Data Exchange data feeds.
Serve as a point of coordination for Data Exchange identification and issue resolution.
Proactively monitor system status to quickly identify potential abnormalities.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They offer full-service health benefit management solutions to employers, TPAs, and health plans.
Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies.
Support for the development and deployment of audit procedures applied to payer data sets.
Partner across teams and with payers to resolve data discrepancies.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. They are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Use your healthcare knowledge to proactively identify unexpected changes in data and investigate root causes by analyzing trends and underlying factors.
Turn insights into actions, transforming your findings into clear recommendations for strategic adjustments, workflow improvements, and smarter investments.
Design, build, and own the development and communication of KPIs for the Provider Operations and Provider Performance teams.
Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. Founded in 2017, they've grown fast and now serve members across the United States.
Lead development of advanced models and experimentation frameworks.
Design, build, and maintain end‑to‑end machine learning pipelines in a cloud based framework.
Develop and refine NLP pipelines to extract structured information from unstructured clinical documentation.
Emory Healthcare is an academic medical center located in Atlanta, Georgia. They are committed to providing reasonable accommodations to qualified individuals with disabilities and is an equal opportunity employer.
First line of defense on data quality and accuracy issues with existing payer data ingestion feeds.
Provide operational support needed to ensure continuity of data exchange between Aledade and payer partners.
Assist in data analysis requests to support net new integrations and investigate investments for new data-based projects.
Aledade empowers independent primary care practices. They are the largest network of independent primary care in the country, helping practices deliver better care and thrive in value-based care.
Create and maintain dashboards to monitor metrics.
Splash Financial helps people with debt by refinancing student loans and credit cards. They have refinanced over $6 Billion in loans and raised over $135 million from investors and operates with a fast-paced, nimble, and heart-filled startup culture.
Work with stakeholders to set and develop metrics to support business decisions and needs
Act as a strategic consultant with stakeholders to develop strategies and drive direct business value with analytics
Architect and build out relevant data pipelines and data models to support downstream data needs
Invisible Technologies makes AI work. They have a end-to-end AI platform structures messy data, automates digital workflows, deploys agentic solutions, measures outcomes, and integrates human expertise where it matters most. The company reached $134M in revenue and ranked as the number two fastest growing AI company on the 2024 Inc. 5000.
Conduct complex analytic studies using statistical techniques on healthcare data.
Present findings through charts, tables, and graphs for easy interpretation.
Create and maintain efficient statistical and analytic code using tools such as Python, SAS, Stata, R.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Conduct in-depth analysis of claim payments, identifying trends and patterns for cost avoidance through internal and external collaboration.
Ensure medical claims comply with guidelines, contracts, and standards while detecting billing inefficiencies and recommending corrective actions.
Provide data-driven recommendations to management on payment-affecting issues, supporting necessary system and policy updates and provider education.
BCBSRI is dedicated to serving Rhode Islanders by providing access to high-quality, affordable, and equitable care. They actively support associate well-being and work/life balance, fostering a culture of belonging where diverse perspectives are valued and employees are equipped for success.
Working collaboratively with stakeholders, address hypotheses across various disease and treatment areas, leveraging the Atropos platform.
Run custom analytics using Atropos Health's proprietary technology stack + industry standard tools and analysis packages.
Own end-to-end hypothesis generation and study generation across multiple health care domains
Atropos Health develops GENEVA™ OS, an operating system for rapid healthcare evidence using real-world data. They aim to transform healthcare with timely, relevant real-world evidence, fostering a diverse, inclusive, and equitable workplace.
Build data pipelines for coaching and user analytics.
Build data systems that power product features.
Establish our data infrastructure and architecture.
Mento is a career technology company that helps people be exceptional and thrive at work through human, AI, and software-based coaching. They strive to create a fun, conscientious, collaborative, and supportive work environment with a unique model of coaching to every member of the global workforce.
Use SQL to analyze clinical, operational, financial, and administrative data generated in Epic’s EHR.
Design, build, and maintain business intelligence dashboards and data pipelines using tools such as Power BI, SQL, and Git.
Develop rigorous data quality tests, QC best practices, code reviews / Git pull requests, and dashboard release processes.
Habitat Health envisions a world where older adults experience independent and joyful aging in their homes with access to comprehensive health care. They provide personalized clinical and social care through the Program of All-Inclusive Care for the Elderly (PACE) in collaboration with healthcare partners.