Data Analyst :: Healthcare Payer domain with AI/ML

Required experience (must-have)

• 8+ years in healthcare insurance (payer) across at least one of: Commercial, Medicare Advantage, Medicaid
• Demonstrated work on core payer functions such as:
• Claims (professional/institutional), EDIs, payments, adjustments, COB
• Utilization management (prior auth), care management, provider network, member enrollment/eligibility
• Grievances/Appeals, fraud/waste/abuse (SIU)

• 3 5+ years delivering data/AI/ML projects end-to-end in production (not just POCs).
• Proven ability to lead cross-functional delivery with business, clinical, IT, and vendors.