Payor Intelligence Sr. Analyst

The role

You will build and own payor intelligence by creating taxonomies, hierarchies, and governance for the payor landscape. You will translate payor data and relationships into product requirements for engineering, clinical, and operations teams.

What you will do

• Build and own payor entity mapping including hierarchies, subsidiaries, TPAs, PBMs, and delegated relationships.
• Source, interpret, and govern medical policies, coverage criteria, government guidance, and fee schedules.
• Design the delegated-relationship logic behind prior authorization.
• Identify and track clinical content sources like InterQual and NCCN.
• Map prospect and customer payor data back to Tennr's payor model.
• Proactively drive projects from conception to completion.

Required qualifications

• 5+ years working across the U.S. payor landscape, including 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.
• Track record of building taxonomies, frameworks, databases, or mapping systems.
• Exceptional analytical and pattern-recognition skills.
• Self-directed ownership of a domain end to end.
• Outstanding communication skills.

Nice to have

• Familiarity with SQL or comparable data tooling

Benefits

• Remote Flexibility
• Unlimited PTO
• 100% paid employee health benefit options
• Employer funded 401(k) match
• Competitive parental leave

About the company

Tennr uses proprietary models to handle complex paperwork to help providers get paid and patients receive care. The company is focused on reducing patient delays across the U.S. healthcare system.