Manager

Product & Workflow Configuration (50%)

• Lead and support the design, configuration, and optimization of audit workflows to enable efficient, scalable, and rule-driven processes.
• Collaborate with product owners and business stakeholders to translate audit scenarios into configurable workflow rules, optimizing end-to-end audit workflows.
• Manage and maintain custom letter templates, ensuring alignment with regulatory requirements, business needs, and system capabilities.
• Support the development and execution of product roadmaps for payment integrity solutions, ensuring alignment with business needs.
• Assist in analyzing claims, provider, and payer data to identify key trends, risks, and opportunities for solution enhancements.
• Collaborate with cross-functional teams (business, engineering, and data science) to develop scalable and repeatable solutions.
• Engage with stakeholders and product owners to gather feedback, refine product requirements, and ensure smooth execution.
• Assist in automation and process improvements to enhance prepay, post-pay, and point-of-service auditing solutions.
• Monitor and report key insights, milestones, and value propositions to leadership and stakeholders.
  

Data & Market Analysis (20%)

• Perform quantitative and qualitative data analysis to support product decision-making.
• Utilize SQL, Excel, and visualization tools to extract and interpret data for process optimization.
• Work closely with finance, reporting teams, and internal platforms to build and maintain valuable KPIs and benchmarks.
• Leverage digital tools (AI, cloud, automation, NLP, etc.) to improve analytics and reporting.
• Identify gaps in payment integrity processes and recommend data-driven improvements.
• Research and recommend market trends, competitive insights, and technology advancements to improve product positioning
  

Stakeholder Collaboration & Communication (30%)

• Act as a bridge between business and technical teams, ensuring clear communication of product vision and priorities.
• Assist in creating presentations, reports, and product documentation to communicate progress and findings.
• Support internal and external messaging to position solutions effectively in the market.
• Develop templates, best practices, and process improvements to streamline solution delivery.
• Participate in cross-functional knowledge sharing with global teams to align strategy and execution
  

Skills & Qualifications

• Experience configuring workflows in healthcare audit, claims, or case management platforms.
• Strong product mindset and innovative capabilities
• Strong analytical and problem-solving skills
• Ability to collaborate with technical teams and understand product development cycles.
• Exposure to data visualization tools for querying and reporting.
• Project management experience with the ability to track multiple deliverables.
• Excellent written and verbal communication skills, including presentation development.
• Strong proficiency in Microsoft Word, PowerPoint, and Excel.
• Prior experience in configuring workflows, claims auditing, payment integrity, or provider reimbursement is a plus.
  

Job Title: Business Systems Analyst

Reports to: