Job Description
📋 Description Own lifecycle of clinical and reimbursement policies Interpret Medicare rules into actionable logic Coordinate with teams to reflect policy in claims systems Manage external vendor relationships and improvements Lead AI-driven policy monitoring and research Research industry/regulatory trends and risks 🎯 Requirements 5+ years in healthcare claims, policy, or related ops Medicare Advantage expertise; Medicare regs knowledge Translate regulatory requirements into operational workflows Experience with AI/LLM tools for research/automation Vendor management and performance evaluation Familiarity with enterprise claims engines and adjudication 🎁 Benefits Competitive base salary: $107,000–$130,000 USD Equity, bonus eligibility, 401(k) matching Medical, dental, vision coverage Flexible time-off and holidays Remote-first with collaboration flexibility No-Meeting Fridays
