Growth opportunities to uplevel your careerA people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our teamCompetitive compensation and comprehensive benefits focused on well-being
An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District , one of the Best Companies to Work For in New York , and an Inclusive Workplace .
About This Opportunity
Qualifications You'll Bring
Bachelor's degree in healthcare administration, business, data science, or a related field or 5 years of equivalent experience in healthcare billing, claims adjudication, payment integrity operations, or healthcare reimbursement analytics
3+ years of experience working with healthcare data analysis, group health business, or provider practice preferred .
Strong experience analyzing large healthcare datasets using SQL or modern data tools (e.g., Snowflake, dbt, Looker, Python)
Experience with claims, payment integrity, or Medical Economics, especially in Medicare Advantage and/or New York Medicaid is a plus
Advanced analytical skills with the ability to interpret complex data and derive meaningful insights.
Detail-oriented with a high level of precision and accuracy in handling critical data. Strong critical thinking, problem-solving, and communication skills (oral and written).
Ability to work independently and collaboratively in a fast-paced, high-growth environment.
Skilled at preparing clear, actionable documentation and executive-level summaries.
Intermediate knowledge of local, state, and federal laws and regulations pertaining to health insurance is a plus.
Your Key Responsibilities
Build, maintain, and enhance data pipelines that support payment integrity and savings analysis initiatives
Analyze healthcare claims data to identify improper payments, wasteful spend, and cost reduction opportunities
Perform deep-dive statistical analysis, predictive modeling, and experimental design to inform business strategies and operational improvement
Conduct detailed reviews of claims history, provider files, and medical reviews to identify billing irregularities and financial trends
Collaborate with cross‑functional partners to quantify and report savings generated by payment integrity activities
Develop and deliver actionable insights and evidence-backed referrals that reduce health insurance costs
Prepare and present savings reports, trending analyses, and recommendations to stakeholders
Identify and resolve data quality issues, including discrepancies or missing data
Ensure all analysis and reporting complies with regulatory requirements and internal policies
Where You'll Be
This is a remote position; however, candidates must reside and work in New York or Vermont.
Pay Transparency
We do not request current or historical salary information from candidates.
$69,383.00-$92,279.00
MVP's Inclusion Statement
At MVP Health Care, we believe creating healthier communitie
Health insurance
Remote work options
Equity / stock options
Additional Information
Join Us in Shaping the Future of Health Care
At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
Mvphealthcare · Remote