Top Tech Jobs & Startup Jobs

Manages healthcare cost reporting, including financial data accuracy, detailed report preparation, reimbursement analysis, regulatory compliance, reporting-system improvements, and management presentations. Collaborates across departments, identifies trends and discrepancies, supports strategic planning, and leads process improvements. Requires expertise in Medicaid cost reporting, healthcare reimbursement, finance technologies, analytics, and staff leadership.

Prepares financial, utilization, revenue, cost, and medical expense analyses and forecasts. Develops and validates reports using claims, eligibility, pharmacy, and clinical data; evaluates contracts and cost-saving initiatives; monitors budgets and variances; researches trends; reconciles data; supports regulatory compliance; and communicates findings to management.

Leads enterprise business analysis strategy across programs and portfolios, partnering with executives to define requirements, evaluate investments, measure business value, manage risks, and guide transformation initiatives. Establishes standards and governance, analyzes operational and financial data, supports regulatory compliance, and mentors analysts. The role also advances AI-enabled tools, automation, and analytics to improve decision-making and business outcomes within a healthcare payer environment.

Owns product strategy, vision, operating models, governance, and roadmaps for data migration, integrations, and enterprise transformation initiatives. Translates business and technical objectives into prioritized delivery plans, coordinates cross-functional teams and vendors, oversees readiness, testing, implementation, stabilization, and transition to operations. Manages risks, dependencies, stakeholder expectations, compliance, and executive reporting while guiding product owners and delivery teams.

Supports membership enrollment and retention through community outreach, educational presentations, direct marketing, relationship management, lead generation, and coordination with community, government, provider, and business organizations. Maintains regulatory compliance, documents sales activity in CRM systems, monitors market trends, and manages territory-based membership goals. The role requires regular travel, health insurance knowledge, state insurance licensing, and collaboration with internal teams.

Provides financial leadership for a healthcare market, including reporting, forecasting, budgeting, financial modeling, reimbursement analysis, regulatory filings, audits, risk assessment, and support for pricing and contracting strategies. The role manages finance staff and budgets, oversees internal controls, coordinates with actuarial and operational teams, and supports market leadership with financial insights and process improvements.

Leads systems research and business analysis to identify impacted systems, interfaces, dependencies, and affected business areas. Elicits and documents requirements, creates Agile features and stories, facilitates stakeholder workshops, performs root cause analysis, supports QA testing, and develops training and documentation. Serves as a liaison between technical teams and business users while analyzing complex processes and enterprise systems in a healthcare environment.

Leads advanced data science and machine learning initiatives for healthcare payment integrity, including fraud, waste, and abuse detection, anomaly identification, predictive modeling, statistical analysis, dashboards, and recovery investigations. Provides technical leadership, mentors analysts, integrates production analytical solutions, collaborates with legal and business stakeholders, and presents findings to leadership. Requires healthcare expertise, advanced SQL and programming skills, and knowledge of claims, billing, reimbursement, and program integrity.

Provides financial leadership for a market or region through reporting, budgeting, forecasting, business reviews, reimbursement and pricing analysis, regulatory filings, audits, risk assessment, internal controls, and quality improvement initiatives. Partners with executives, regulators, actuaries, providers, and market leaders while managing finance staff and supporting growth, revenue maximization, and strategic decision-making.

Leads ElderServe Health’s legal, compliance, regulatory, governance, and risk functions. Advises executive leadership, oversees legal and regulatory strategy, ensures compliance with healthcare laws and government program requirements, manages significant transactions and partnerships, represents the organization with regulators and stakeholders, and develops departmental capabilities, budgets, talent, and performance measures.