Complex Clinical Audit Business Solutions Lead

Posted

abacusinsightsRemote - USRemotefull_timelead

Tech Stack

Responsibilities

  • Serve as the primary operational subject matter expert for payment integrity methodologies, audit programs, and product requirements.
  • Translate payer pain points, contract language, audit policy, and operational workflows into product capabilities.
  • Define audit concepts, savings opportunities, validation criteria, and defensibility standards across priority PI domains.
  • Partner with engineering to define, develop, and build high-performing, scalable, trustworthy, reliable, and accurate AI solutions.
  • Support roadmap prioritization, pilot launches, outcome reviews, positioning, and customer expansion.

Soft Skills

Payment IntegrityDrg ValidationClinical Claim ReviewProduct ManagementSoftware WorkflowsData AnalysisStakeholder ManagementHealthcare Interoperability Standards

Benefits

  • Equity
  • Health Insurance
  • Home Office Budget
  • Remote Work
  • Unlimited PTO

Culture

Collaborative SpaceHome Office BudgetInclusive HiringPay Transparency

Requirements

Regions: Us

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About abacusinsights
Industry: healthtech
Size: medium

Abacus Insights is transforming how data works for health plans by building a single, trusted data foundation to support better decision-making.

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Compensation
Equity: Equity grants
Bonus: Eligibility for performance bonuses