Job Description: Senior Manager, Claims Analytics
Role: Senior Manager, Claims Analytics
Team: Implementation, GTM
Reports To: VP of Implementation, Cliff Walker
Role Overview
The Senior Manager, Claims Analytics, leads the claims analytics function within the
Implementation organization. This role is responsible for overseeing complex reimbursement
and payment accuracy analyses, managing analysts, setting analytical standards, and
partnering cross-functionally with GTM, Customer Success, Product, and Engineering teams to
ensure successful client implementations.
This role combines deep healthcare claims expertise with people leadership, strategic thinking,
and operational execution to scale analytics capabilities and drive measurable financial
outcomes for clients.
Key Responsibilities
Leadership & Strategy
● Lead and mentor a team of Implementation Claims Analysts, setting priorities,
performance expectations, and development plans. Define and standardize analytical
methodologies, reporting frameworks, and best practices for claims and reimbursement
analysis.
● Partner with Implementation leadership to align analytics deliverables with client goals,
timelines, and success metrics.
● Act as a subject-matter expert in claims analytics for complex or high-visibility client
implementations.
Analytics & Execution
● Oversee large-scale analysis of claims data related to charge capture, reimbursement,
underpayment, overpayment, and payment accuracy.
● Ensure the delivery of exception-driven, actionable insights that clearly identify systemic
versus isolated issues.
● Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in
reporting and client-facing deliverables.
● Guide analyses related to:
○ Payor reimbursement behavior and trends
○ RVU productivity and payment alignment
○ Revenue cycle optimization opportunities
○ Financial performance to benchmarks, goals, and norms
Cross-Functional Collaboration
● Partner with GTM and Customer Success teams to support implementations, renewals,
and expansion opportunities through analytics insights.
● Collaborate with Product and Engineering teams to influence roadmap priorities based
on claims analysis findings and client needs.
● Serve as a senior analytics representative in client-facing discussions, executive
readouts, and strategic reviews.
Technical Oversight
● Provide guidance on data ingestion and processing pipelines using SQL*Loader, Oracle,
shell scripting, and cloud-based tools.
● Oversee advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and
AWS.
● Ensure scalable, repeatable approaches to analyzing billions of claims records across
clients.
Required Qualifications
● 8+ years of experience in healthcare claims analytics, payment accuracy, or
reimbursement analysis.
● Prior experience working with claims editing or payment accuracy vendors.
● Strong expertise in medical coding, billing guidelines, and reimbursement
methodologies.
● Proven people leadership experience managing and developing analytics teams.
● Advanced proficiency in SQL and experience working with large healthcare datasets.
● Strong executive communication and presentation skills.
Core Competencies
● Strategic thinking with a strong bias toward execution
● Ability to lead through ambiguity and change
● High accountability and ownership mindset
● Strong client-facing presence and stakeholder management skills
● Passion for building scalable analytics capabilities and high-performing teams
Senior Manager, Claims Analytics (Rialtic)
Role: Senior Manager, Claims Analytics
Team: Implementation
Reports To: VP of Implementation
About the Role
The Senior Manager, Claims Analytics, leads Rialtic’s claims analytics function within
Implementation. This role is responsible for scaling analytical rigor, leading high-impact client
work, and developing a team that consistently delivers clear, defensible, and outcome-driven
insights.
You will combine deep healthcare reimbursement expertise with strong people leadership and
cross-functional collaboration. This role is both strategic and hands-on: setting direction,
reviewing complex analyses, and serving as a trusted analytics partner for clients and internal
stakeholders.
What You’ll Do
Lead & Scale the Function
● Establish analytical standards, methodologies, and best practices across
implementations.
● Set priorities and ensure on-time, high-quality delivery of analytics work across multiple
client engagements.
● Act as a senior subject-matter expert for complex or high-visibility implementations.
Drive Analytics That Matter
● Oversee large-scale analysis of claims data related to payment accuracy, charge
capture, reimbursement, and revenue integrity.
● Ensure analytics outputs are exception-driven, actionable, and defensible, clearly
separating systemic issues from isolated findings.
● Review and validate complex analyses and client-facing deliverables for accuracy,
clarity, and impact.
● Guide analytical work focused on:
○ Payor reimbursement behavior and contract performance
○ Underpayment and overpayment trends
○ RVU productivity relative to payment outcomes
○ Revenue cycle and billing optimization opportunities
Partner Across Rialtic
● Collaborate closely with GTM and Customer Success to support implementations,
renewals, and expansion opportunities.
● Partner with Product and Engineering teams to inform roadmap priorities based on
real-world claims insights.
● Serve as a senior analytics voice in client discussions, executive readouts, and strategic
reviews.
Technical & Analytical Oversight
● Provide direction on data ingestion and processing using SQL*Loader, Oracle, and shell
scripting.
● Guide advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and AWS.
● Ensure scalable, repeatable approaches to analyzing billions of claims records across
clients.
What We’re Looking For
● 8+ years of experience in healthcare claims analytics, payment accuracy, or
reimbursement analysis.
● Prior experience with claims editing or payment accuracy vendors.
● Deep knowledge of medical coding, billing guidelines, and reimbursement
methodologies.
● Proven experience leading and developing analytics teams.
● Advanced SQL expertise and experience working with large healthcare datasets.
● Strong executive-level communication and client-facing skills.
What Makes You Successful at Rialtic
● Comfortable owning outcomes, not just analysis
● Able to lead through ambiguity and evolving requirements
● Strong judgment in balancing speed, rigor, and practicality
● Trusted partner to clients and internal stakeholders
● Passion for building scalable analytics and high-performing teams
About the Role
The Senior Claims Analytics Lead is a senior individual contributor within Rialtic’s
Implementation organization, responsible for delivering rigorous, defensible claims analytics that
drive measurable financial outcomes for clients.
This role is hands-on and highly analytical. You will independently lead complex claims
analyses, translate large-scale healthcare data into actionable insights, and serve as a trusted
subject-matter expert during client implementations. You will partner closely with Implementation
leadership, GTM, Customer Success, Product, and Engineering while maintaining end-to-end
ownership of analytical quality and outcomes.
What Is Required
● 8+ years of experience in healthcare claims analytics, payment accuracy, or
reimbursement analysis
● Prior experience with claims editing or payment accuracy vendors
● Deep knowledge of medical coding, billing guidelines, and reimbursement
methodologies
● Advanced proficiency in SQL and experience analyzing large healthcare datasets
● Strong hands-on analytical skills with the ability to independently own complex analyses
● Experience producing clear, client-ready insights and executive-level readouts
● Comfort working cross-functionally and operating in ambiguous, fast-moving
environment