Abacus Insights

Abacus Insights

Senior Consultant, Payment Integrity

United States · Senior

Sponsorship not specified$23k-$48kDetected 9 days ago
SnowflakeDatabricksComplianceAuditingProcess ImprovementResearchLeadershipCommunicationProblem SolvingPublic SpeakingAdaptability

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odds of building a lasting career here

37Risky
Cap-exempt (no lottery)0
Sponsors this role80
Entry-level history0
PERM / green-card track0
Lottery odds (Level I)39
Fits your clock70

Thin sponsorship signal and lottery-bound (~15% per draw). A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.

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Employer immigration record

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Files H-1B transfers

1 transfer filing in the last year, covering 1 worker. Median labor-condition decision: 7 days. An employer that already files transfers is one that can take over an existing H-1B.

Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.

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About the role

  • Payment Integrity is one of the highest-stakes problems in healthcare, and you'll be Abacus' internal authority on it: the trusted advisor and go-to Subject Matter Expert who helps us solve it right.
  • You can investigate a market trend, structure a policy recommendation, and walk an executive team through why it matters, all in the same week.
  • This role sits at the intersection of payment integrity policy, regulatory compliance, and hands-on AI-enabled delivery.

Responsibilities

  • Your work spans from diagnostics and market and regulatory research, through policy and rule design, to hands-on configuration, testing, and payer-facing rollout.
  • Own workstreams on client engagements from scoping and hypothesis development through analysis, recommendation, and implementation
  • Research contracts and design tailored payment integrity strategies, policies, and roadmaps aligned with sponsor goals and industry best practices
  • Create and maintain payment integrity policy for external communication, and lead cross-functional teams through implementation
  • Manage client relationships and expectations day to day, including scope, timelines, risks, and value realization, in partnership with the Engagement Manager
  • one-time support to get you started
  • Therefore, we dedicate resources to building diverse teams and providing equal employment opportunities to all applicants.
  • At the heart of who we are is a commitment to continuously and intentionally building an inclusive culture-one that empowers every team member across the globe to do their best work and bring their authentic selves.
  • We carry that same commitment into our hiring process, aiming to create an interview experience where you feel comfortable and confident showcasing your strengths.
  • If there's anything we can do to support that-big or small-please let us know.

Requirements

  • Familiarity with provider risk arrangements (delegated risk, capitation, risk panels) and how payment integrity policy applies to them
  • Working knowledge of federal, state, and ERISA regulations, and experience identifying and mitigating fraud, waste, and abuse, including reviewing contracts for compliance and responding to audits and escalated appeals

Skills

  • Contribute to Abacus' consulting methodologies, reusable frameworks, accelerators, and thought leadership as our advisory practice scales

Compensation

  • Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.

Benefits

  • We typically see 5+ years of consulting experience, including client-facing delivery within a healthcare payer practice, ideally in payment integrity, claims, or reimbursement
  • 10+ years of total experience in healthcare payment integrity, claims auditing, or reimbursement analysis (consulting or industry), with comfort working across clinical, operational, and data domains
  • Unlimited paid time off:
  • Comprehensive health coverage:
  • Equity for every employee:
  • Home office setup allowance:

Company info

  • Abacus Insights is transforming how data and AI work for health plans. Our mission is simple: make healthcare data usable, so the people responsible for care and cost decisions can act faster, with confidence.
  • As the AI and Data Platform for Payer Intelligence, we help health plans break down data silos to create a single, trusted data foundation. That foundation powers better decisions-so plans can improve outcomes, reduce waste, and deliver better experiences for members and providers alike. Backed by $100M from top investors, we're tackling big challenges in an industry that's ready for change. Our platform enables GenAI use cases by delivering clean, connected, and reliable healthcare data to support automation, prioritization, and decision workflows-and it's why we are leading the way.
  • Our innovation begins with people. We are bold, curious, and collaborative-because the best ideas come from working together. We embrace the thoughtful use of AI and automation to drive innovation and efficiency, and we look for individuals who are curious and adaptable-those excited to leverage emerging technologies to enhance how we work-while keeping human insight, connection, and our clients at the center of every decision.
  • Ready to make an impact? Join us and let's build the future together.
  • Abacus Insights is transforming how data and AI work for health plans.
  • Our mission is simple: make healthcare data usable, so the people responsible for care and cost decisions can act faster, with confidence.
  • As the AI and Data Platform for Payer Intelligence, we help health plans break down data silos to create a single, trusted data foundation.
  • That foundation powers better decisions-so plans can improve outcomes, reduce waste, and deliver better experiences for members and providers alike.
  • Backed by $100M from top investors, we're tackling big challenges in an industry that's ready for change.
  • Our platform enables GenAI use cases by delivering clean, connected, and reliable healthcare data to support automation, prioritization, and decision workflows-and it's why we are leading the way.
  • Our innovation begins with people.
  • We are bold, curious, and collaborative-because the best ideas come from working together.
  • We embrace the thoughtful use of AI and automation to drive innovation and efficiency, and we look for individuals who are curious and adaptable-those excited to leverage emerging technologies to enhance how we work-while keeping human insight, connection, and our clients at the center of every decision.
  • Ready to make an impact?
  • Join us and let's build the future together.
  • Our mission is simple:
  • make healthcare data usable, so the people responsible for care and cost decisions can act faster, with confidence.

Equal opportunity

  • Our Commitment as an Equal Opportunity Employer
  • Virtual or blurred backgrounds and headsets are not permitted absent an approved accommodation, and you should be in a well-lit, private space where your face and surroundings are clearly visible.

Visa & Work Authorization

  • Experience developing, writing, and presenting payment integrity policy, strategy, and roadmaps for executive and sponsor audiences, backed by a strong grasp of reimbursement models, payer/provider operations, and regulatory considerations
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This listing is sourced directly from Abacus Insights's careers page and normalized into a canonical job model.