Senior Payor Intelligence Analyst

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $90k - $110k / year

⏰ Full Time

🟠 Senior

🕵️ Threat Intelligence Specialist

👻 Ghost score 2%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Tennr (YC W23)

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

☁️ SaaS

🏢 Enterprise

Healthcare • SaaS • Enterprise

Tennr is a company that enables healthcare practices of all sizes to optimize their back-office operations with enterprise quality automations. The company focuses on streamlining processes in the healthcare sector, aiming to enhance efficiency and effectiveness in healthcare management.

📋 Description

• Build and own payor entity mapping, including hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships • Source, interpret, and govern medical policies, coverage criteria, government guidance, and fee schedules • Establish effective dating, provenance, and version control for policy information • Design delegated-relationship logic behind prior authorization • Determine which entity owns the decision for a given plan, product, and service • Identify and track clinical content sources such as InterQual and NCCN • Own contracting requirements and timing for clinical content sources • Map prospect and customer payor data to Tennr's payor model • Turn recurring manual work into a repeatable system • Drive projects from conception to completion • Contribute to company growth and success • Collaborate with engineering, clinical, and operations teams • Collaborate and connect with colleagues in the Hudson Square office, with quarterly office travel

🎯 Requirements

• 5+ years working across the U.S. payor landscape • Breadth across Medicare, Medicare Advantage, Medicaid and MCOs, and commercial lines of business • Fluency in payor structure, including payor families, subsidiaries, TPAs, PBMs, delegated entities, regional versus national plans, and self-funded versus fully insured arrangements • Experience researching and interpreting payor policies, government guidance, fee schedules, or clinical guidelines • Experience reconciling sources that disagree with each other • Track record of building taxonomies, frameworks, databases, or mapping systems • Exceptional analytical and pattern-recognition skills • Investigative instinct to work from ambiguous and incomplete information • Self-directed ownership of a domain end to end • Outstanding communication skills • Familiarity with SQL or comparable data tooling is a plus • Ability to work in the U.S. payor landscape • Required application of work authorization or visa sponsorship status

🏖️ Benefits

• Equity • Bonus • Remote Flexibility • Unlimited PTO • 100% paid employee health benefit options • Employer funded 401(k) match • Competitive parental leave • Travel to Hudson Square office on a quarterly basis