Analyst, Payer Strategy

Posted 12 Days Ago
Be an Early Applicant
Hiring Remotely in San Francisco, CA, USA
In-Office or Remote
95K-120K Annually
Mid level
Artificial Intelligence • Healthtech • Software • Analytics
The Role
Analyze dispute outcomes and claims data to build payer profiles, model offer strategies, run loss analysis, benchmark versus CMS data, and convert insights into automated product rules and team dashboards.
Summary Generated by Built In
Figure out how payers behave, then turn that into offers that win.


Why This Exists

A federal arbitration system called Independent Dispute Resolution, or IDR, now determines billions of dollars in healthcare payments each year. Providers win the vast majority of disputes, yet most eligible claims are never filed. The process is manual, fragmented, and resource-intensive, and most providers don't have the infrastructure to pursue what they're owed.

The No Surprises Act created the framework, and the market already exists. Today it runs on spreadsheets, consultants, and static playbooks. We're building the first intelligent system designed to operate inside it.

IDR is a repeated game. The same payers and the same arbitrators show up again and again. Whoever learns fastest from outcomes builds a compounding edge that nobody can copy. This role is how we learn.


Why This Is Hard (and Interesting)

Every dispute produces signal. Which claims won, at what offer multiple, against which payer, in front of which arbitrator, with which evidence. Most of the industry throws that signal away. We want to capture all of it and turn it into a system that gets sharper every month.

The hard part is that the signal is noisy and the sample is small at first. Payers change behavior. Arbitrators rotate. Regulations shift under you. You need enough statistical honesty to know when a pattern is real and enough operator judgment to act before you have perfect data.

You'll spend your time in claims data, decision letters, and remittance files, looking for the thing nobody has noticed yet. Then you'll turn it into a rule the system can apply.


Who We Are

Recourse is being built in partnership with 25M Health, a healthtech venture firm. We have institutional backing, a shared platform team spanning engineering, strategy, design, and back-office, and early access to large provider systems.

We are actively filing disputes for real customers, including a large multi-facility health system and a litigation-finance partner with hundreds of millions in claim value. This is a funded, validated opportunity with real customers and real data.

We are a small, nimble team. We move quickly and we value clarity over theater. We want this to be the best work of your career. The stretch you look back on as the one where you shipped real things, with people who raised your game, on something that mattered.

We care about clear thinking, high ownership, intellectual honesty, and direct communication. We believe operations, product, and engineering should operate as one pod, not three functions. We want the machines to do machine work, and the humans to do their best work.


The Role

You'll own the intelligence layer underneath our offer strategy. You will:

  • Analyze outcomes across every dispute we file: win rate, offer multiple, recovery, time to resolution
  • Build payer profiles that explain how each insurer behaves and where they can be pushed
  • Run loss analysis on every dispute we don't win, and turn the reason into a rule
  • Model offer strategy: what to submit, against which payer, for which CPT context, and why
  • Work with CMS public use file data to benchmark our performance against the whole market
  • Partner with engineering to encode what you learn into the product, so the system applies it automatically
  • Build the dashboards and reporting the whole team runs on

You'll write specs, SQL, and analysis that gets built against. You'll also be in the claims themselves often enough to keep your instincts honest.


Who You Are

You are genuinely analytical. Not "comfortable with Excel" analytical. You can look at a messy dataset, form a hypothesis, test it, and know the difference between a real pattern and noise.

You are AI-pilled. You've used AI tools to do analysis that would have taken a team. You have opinions about which ones are useful and which are hype. You stay current because the world is changing and you want to see the next shift before anyone else.

You are intellectually honest. You seek out the data that might disconfirm your belief, not just confirm it. You say when a finding is weak. You use plain language when explaining what you found.

You have a bias to action. You don't wait for perfect data. You form a view, act on it, measure, and adjust. Most decisions are reversible and do not need extensive study.

You care about the details. In this work, a small pattern in how a payer codes an EOB can be worth real money. You notice things.

You put the team first. You are reliable and fully invested. You take your vacations. You check on your teammates. You help build a culture where people do their best work because they are supported, not squeezed.


What You Bring

  • 3+ years in analytics, data science, strategy, or a similarly quantitative role
  • Strong SQL. You pull your own data and you don't wait for someone else to do it
  • Comfort with Python or R for anything SQL can't handle
  • Healthcare data experience is a strong plus: claims, 835s, EOBs, CPT and diagnosis coding, payer contracting
  • Hands-on fluency with AI tooling. You have used it to accelerate real analytical work, not just tried the demos
  • Clear written communication. Your analysis has to change what other people do, which means they have to understand it
  • A preference for small teams and early-stage chaos over mature org charts

Strong plus, not required: experience with the No Surprises Act, IDR, arbitration, payer contracting, or out-of-network claims. If you have it you'll move faster. If you don't, we'll teach you.

Sound judgment, analytical depth, and ownership mindset are required. Grit matters more than pedigree.


Why This Role

Most analytics jobs produce dashboards nobody looks at. This one directly sets the number we submit on every dispute, which directly determines whether a provider gets paid.

You'll also be building something genuinely novel. Nobody has a real intelligence layer on IDR yet. The public data exists, the outcomes exist, and almost nobody is doing the work to connect them. You'd be first.

If you want this to be the most memorable stretch of your career, where you shipped something real, with a team you respected, in a domain that actually matters, this is the seat. Please apply even if you don't fit 100% of these requirements. We would like to talk.


Equal Opportunity

Recourse is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We believe the best teams are built from people with different backgrounds and perspectives, and we're committed to creating an environment where everyone can do their best work.

Compensation
The base pay range for this role is $95,000 – $120,000 per year.

Skills Required

  • 3+ years in analytics, data science, strategy, or a similarly quantitative role
  • Strong SQL (able to pull and manipulate own data)
  • Comfort with Python or R for analysis beyond SQL
  • Hands-on fluency with AI tooling used to accelerate analytical work
  • Clear written communication; ability to write specs and actionable analysis
  • Analytical judgment with messy datasets and statistical rigor
  • Healthcare data experience (claims, 835s, EOBs, CPT/diagnosis coding, payer contracting)
  • Experience with No Surprises Act, IDR, arbitration, or out-of-network claims
  • Preference for small teams and early-stage, ambiguous environments
  • Bias to action, attention to detail, and strong team orientation
Am I A Good Fit?
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The Company

What We Do

Recourse Health builds claims-intelligence software for healthcare providers, automating the manual, resource-intensive IDR and out-of-network dispute workflows created by the No Surprises Act. The company uses AI and LLM-powered reasoning to ingest claims, package evidence, and operate end-to-end dispute workflows so providers can pursue disputed payments at scale while preserving auditability and regulatory compliance.

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