Business Analytics Senior Manager Payment Integrity - Risk & Affordability (Remote)
$130.9k - $218.1kCarepathRx
Business Analytics Senior Manager
The Payment Integrity & Affordability Governance organization partners across the enterprise to deliver insights that help reduce healthcare costs, improve outcomes, and strengthen financial sustainability. Our work supports both internal and external partners by translating complex data into clear, actionable strategies.
The Payment Integrity Analytics Team focuses on measurement and analytics for national Payment Integrity programs—helping leaders understand the future strategy and current program performance including what's working, where opportunities exist, and how we can continue to improve affordability and customer experience at scale.
About the Role:
As a Business Analytics Senior Manager, you'll lead a team of analysts supporting Payment Integrity initiatives. This role blends healthcare data analytics and AI, financial insight, and people leadership, with a strong emphasis on influencing decisions at the executive level. The role will also be responsible for comprehensively looking at the provider and payer landscape to identify and drive innovative approaches for understanding medical cost trends, provider behavior, provider billing behavior, and healthcare industry operations to streamline medical costs for health plan members.
This role will partner closely with stakeholders across finance, operations, clinical, product and network teams to evaluate trends, support proposals, and ensure accurate financial measurement for new programs and initiatives.
This is an ideal role for a leader who enjoys connecting strategy to execution—and who wants their work to directly impact healthcare affordability.
What You'll Do:
- Lead strategic analytics by identifying medical cost drivers and trends, risks, and affordability opportunities.
- Develop and execute analysis and AI to support Payment Integrity strategies at the enterprise level driving alignment across various business units to ensure enterprise financial goals & priorities
- Tell the story behind the data, translating analytical findings into clear, executive-ready insights that influence decisions across technical, operational, and senior leadership audiences.
- Own financial business cases for new affordability initiatives, including forecasts, variance analysis, and recommendations to improve performance.
- Support Payment Integrity by overseeing analytics for initiatives, policy changes, and ongoing performance monitoring.
- Improve reporting and visualization by assessing current capabilities and advancing self-service analytics solutions, utilizing AI to optimize quality, accuracy and reporting (e.g., Databricks, Tableau, Claude, Cursor or similar tools).
- Modernize analytics through scalable methods, automation, and thoughtful use of AI-enabled tools where they add value.
- Monitors and conducts research of related affordability, AI, business trends, using data and qualitative performance measures, to advise senior management relative to Payment Integrity strategy.
- Manage and develop a team of analysts, setting clear priorities, ensuring high-quality output, and supporting continuous skill development.
- Balance multiple initiatives by prioritizing and delegating work effectively in a fast-paced, dynamic environment.
- Ensure data quality and accuracy by implementing appropriate checks, controls, and processes.
- Act as a trusted thought partner to senior leaders by proactively identifying insights, risks, and emerging trends that inform near- and long-term affordability strategy
What You'll Bring:
- Proven ability to translate complex analyses into actionable business insights.
- Clear, confident communication skills with experience presenting to senior and executive audiences.
- Demonstrated success managing multiple priorities and leading teams in a matrixed environment.
- A creative, critical thinker with strong attention to analytical accuracy.
- Comfortable working independently while collaborating closely with cross-functional partners.
- Self-starter with a strong orientation toward continuous improvement, ownership, and impact
Requirements:
- Bachelor's degree or equivalent in a quantitative field such as Economics, Finance, Data Science or Analytics, Business, Applied Mathematics, Public Health, Actuarial Science or similar. Master's degree preferred
- 7+ years of progressive experience in predictive analytics, financial modeling, healthcare economics, or related fields, including experience leading or mentoring analysts
- Strong analytical and technical skills, with hands-on experience using tools such as SQL, Excel, SAS, Databricks, Tableau, or similar platforms
- Experience with and knowledge of medical claim coding, and provider reimbursement
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 130,900 - 218,100 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process, please email View email address on click.appcast.io for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
$112.8k - $188k
...Senior Advisor As a Senior Advisor, you... ...provide strategy and analytical support for the Payment Integrity team inclusive of... ...insights, business cases and identify... ...toward enterprise affordability goals. What You... ...identifying trends, risks, and affordability...Remote workSeniorRiskWork from home- ...arrangements that include remote and hybrid... ..., you’re an integral part of our... ...high-quality, affordable, and equitable... ...contracting, and other business areas to ensure... ...alternative payment models drive... ...actuarial support for risk adjustment and... ...results.Strong analytical, communication,...Remote workRiskContract workWork at officeWork from homeFlexible hoursShift work1 day per week
- ...Health Care Service Corporation is seeking a Sr. Manager of Payment Integrity Operations based in Chicago, IL. This role is vital in managing daily... ...effective use of enterprise information to deliver business value. The ideal candidate will have a Bachelor’s degree in...Remote workSenior
- ...Senior Manager Of Fraud Strategy And Analytics As a Senior Manager of Fraud Strategy... ...protecting small businesses' hard earned money... ...identity, payments, and other ever-evolving... ...emerging fraud risks. Play an active... ...and manage their integration into production and...Remote workSeniorRisk
$69.4k - $99.2k
...Senior Analyst - Payment Integrity Analytics Be part of a team that unleashes the power of leading-edge technologies... ...or statutory changes to reduce FWA risk and close program gaps. What we... ...and OIG stakeholders Fully remote opportunity with the option to work...Remote workSeniorRiskFull timeWork at officeFlexible hours$87.7k - $157.8k
...Provides trusted advisory support to business and compliance leadership by... ...partners closely with the Sr. Manager, Medicare Compliance Advisory,... ...documentation of compliance risks, trends, and corrective... ...flexible approach to work with remote, hybrid, field or office work...Remote workSeniorRiskFull timePart timeWork at officeFlexible hours$98.2k - $163.6k
As a Business Analytics Advisor, you’ll lead complex strategy and analytical... ...medical cost trend management. What You’ll Do: Lead end-to... ...of healthcare data, claims payment processes, eligibility, benefit... ...actionable business insights for senior and executive stakeholders....Remote workRiskFull timeLocal areaWork from home$176.16k - $250.7k
...team The Core Payments team has been... ...is seeking a Senior Payments Strategy Manager to own the... ...Finance, Legal, Risk, and external... ...alignment, integrations, and performance... ...subscription business globally. For... ...Strong analytical skills including... ...flexible for remote work except for...Remote workSeniorRiskWork at officeLocal areaWorldwideMonday to ThursdayFlexible hours$110k - $160k
...Allstate Insurance is seeking a Fraud Risk Management Senior Manager to lead the Fraud Risk and Return Management team in Chicago, Illinois.... ...leadership while coordinating fraud-related issues across business units. This role involves advocating for fraud prevention initiatives...Remote workSeniorRisk- ...PayPal is seeking a Senior Manager of Network Compliance and Payment Partner Oversight in San Jose, California. This... ...oversee compliance activities, manage risk, and ensure alignment with... ...model, providing flexibility between office and remote work. #J-18808-Ljbffr...Remote workSeniorRiskWork at office
- ...health system. With fully integrated solutions, Valenz... ...care navigation and management to payment integrity, plan performance... .... You'll provide risk-based compliance... ...Administration, Finance, Business Administration, or a... ...Work: This is a fully remote position, and we’ll...Remote workSeniorRiskFull timeImmediate startFlexible hours
$33.45 - $48.09 per hour
...ITPA12 - Senior Integration Business Analyst Print ( Apply ... ...Permanent Full Time Remote Employment... ...Department Technology, Management and Budget Opening... ...agency of impact and risks, including disaster... ...benefits and Michigan’s affordable cost of living, you...Remote workSeniorRiskHourly payPermanent employmentFull timeWork at officeImmediate startRelocationRelocation packageFlexible hours$180k - $225k
NMI is a payments platform that underwrites and bears risk across both card acceptance... ...are hiring a Senior Director of... ...risk management as a competitive... ...that lets the business move faster than... ...Officer Location: Remote, US. Travel to... ...each other. Integration Your first...Remote workSeniorRiskFull timeTemporary workInterim roleLive inFlexible hours$110k - $125k
...Senior Risk, Fraud and Payments Manager New Jersey, United States Are you an experienced... ...: 100% Onsite (Hybrid, Remote not available) The... ...~ Bachelor's degree in Business, Criminology, Finance, or... ...identity fraud. ~ Advanced analytical skills with the ability to...Remote workSeniorRiskFull timeWork at officeLocal area$151k - $190k
...Senior Vice President, Metrics and Analytics Manager The Bank of New York Mellon... ...summarizing business, financial, and... ...objectives. Remote work may be permitted... ...build credit risk, and KPI's;... ...system integration services to deliver... ...discretionary payment or compensation...Remote workSeniorRiskTemporary work- ...Programs, Compliance & Data Analytics Senior Manager at Southern... ...ownership of data strategy, business intelligence, and... ...and implements risk-based assessment plans... ...standards of conduct and integrity. Minimum Qualifications... ...the option to work remotely on the remaining days...Remote workSeniorRiskRelocation
$50k
...banking and financial management platform for... ...We're hiring a Senior Manager, Fraud & Payments Risk to lead Baselane's... ...processes with the business. What You'll Do... ...already exists ~ Analytically rigorous: you ground... ...flexible hours Remote-first work environment...Remote workSeniorRiskWork from homeHome officeFlexible hours- ...help them achieve their business outcomes by providing... ...the ServiceNow Risk & Resilience products... ...• Develop required integration components (REST/SOAP... ...ServiceNow Integrated Risk Management (IRM) configuration/development... ...personas (flexible, remote, or required in office...Remote workSeniorRiskWork at officeFlexible hours
- ...cross-border payments faster, more affordable, and more accessible... ...our Credit Risk function from... ...for a Senior Credit Risk Analyst... ...line by managing credit policies... ...lead credit analytics owner for the... ...). Model Integration & Testing: Partner... ...plans Remote work...Remote workSeniorRiskWork at office
- ...contribute to the company’s success. As a Senior Business Analytics Manager, within PNC's Strategy & Planning... ...may be performed remotely, at the manager’s discretion. Experience... ...provided is accurate, meaningful, has integrity, manages risk and meets the needs of the senior...Remote workSeniorRiskFull timeTemporary workPart timeWork experience placementWork at office
$85k - $99k
...We are seeking a highly analytical operator to help manage the performance, reliability... ...identify delivery or compliance risks before they become major... .... This role is fully remote. This is a temporary hire... ...Sheets/Excel/Airtable, business intelligence platforms, and...Remote workSeniorRiskFull timeTemporary workImmediate startShift work- ...Senior Principal The Senior Principal will be a... ...drive value with data and analytics during times of... ...including both company management (including c-suite) and... ...analysis, developing business processes and data management... ...areas of potential risk and obstacles to...Remote workSeniorRiskPermanent employmentFull time
$140k - $150k
...TYPE: Full Time Remote LOCATION... ...role leads the analytical work that... ...turn ambiguous business questions into... ...role. It is a senior individual contributor... ...clear logic, risks, and proposed... ...performance management preferred ~... ...our purpose. Integrity - We do what...Remote workSeniorRiskFull timeTemporary workWork at office$130k - $165k
...Sr. Account Executive (Payment Integrity) US - Remote Shift is the leading AI platform... ..., claims, and fraud and risk - driving operational... ...experiences and measurable business impact. Trusted by the world... ...business units (Utilization Management, Provider Management, CFO,...Remote workSeniorRiskContract workApprenticeshipInternshipFlexible hoursShift work$140k - $150k
...Type: Full Time Remote Location... ...role leads the analytical work that underpins... ...ambiguous business questions into... ...role. It is a senior individual... ...clear logic, risks, and proposed... ...and performance management preferred ~... ...our purpose. Integrity: We do what we...Remote workSeniorRiskFull timeTemporary workWork at office- ...designed to help customers manage cash flow, build... ...looking to strengthen our risk leadership as we... ...Overview We’re hiring a Senior Risk Analytics Manager to own and evolve... ...into practical business decisions What We Offer... ...real decision authority Remote-friendly culture and flexible...Remote workSeniorRiskFlexible hours
- ...Summary The Senior Manager of Integrated Business Planning Analytics leads analytics to enable long-term supply and demand alignment for a global retail organization... ...identify lost sales opportunities, quantify demand risk, and recommend actions to senior leadership. Oversee...SeniorRisk
- ...sustainable materials management solutions that reduce... ...environment. Our Business Reworld partners with... ...the role The Senior Integration Manager is responsible... ...synergy delivery and risk management, and... ...below. #LI-JP1 #LI-Remote All Reworld positions...Remote workSeniorRiskHourly pay
- ...for Plaid's suite of money movement and payments products. Numerous companies depend on our... ...operational support to our Banking Partners and Business Customers. In addition to a solid... ...in an ACH payments-focused operations or risk environment, with demonstrated ownership...Remote workSeniorRiskDaily paidWork experience placementLocal area
$120k - $160k
...Team The Risk and Fraud Operations... ...Raisin's business by monitoring, assessing... ...responsible for managing fraud prevention... ...As the Senior Fraud Strategy and Analytics Manager, you will... ...fraud across our payment rails.... ...Engineering to integrate these models into...SeniorRiskWork from homeWorldwideFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Business Analytics Senior Manager Payment Integrity - Risk & Affordability (Remote). Be the first to apply!
- business opportunity manager United States
- business systems manager United States
- hr business partner manager United States
- business project manager United States
- business affairs manager United States
- food business manager United States
- information technology business manager United States
- business strategy manager United States
- director business planning United States
- business director United States

