Abacus Insights

Complex Clinical Audit Business Solutions Lead

Remote - US

Sponsorship not specifiedDetected 4 days ago

Data StructuresData ScienceNLPLLMsProduct StrategyVendor ManagementCustomer SuccessLeadershipCommunicationAdaptabilityClaims Management

About the role

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.
5-10+ years of progressive experience in Payment Integrity, healthcare audit, clinical operations, or healthcare technology product management.

Responsibilities

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.
Understanding of payer regulatory, compliance, and audit considerations that impact payment integrity program design and execution.
Experience partnering directly with Product Management, Engineering, Data Science, AI Engineering, or Clinical Informatics teams to build software solutions.
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

What we would like to see, but not required

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

Unlimited paid time off - recharge when you need it
Comprehensive health coverage - multiple plan options to choose from
Equity for every employee - share in our success
Home office setup allowance - one-time support to get you started
Utilize internal AI-enabled tools to quickly create prototypes, visualize workflows, and showcase product functionality, enabling effective communication of product vision and business value.
Compensation: Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.

Company info

Abacus Insights is transforming how data works 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.
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 works 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.
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.
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

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This listing is sourced directly from Abacus Insights's careers page and normalized into a canonical job model.