Payor Intelligence Analyst (Healthcare)

Location: Remote; collaboration with the Hudson Square office, including quarterly office travel.

Compensation: $90,000–$110,000 per year, plus equity and bonus opportunities.

Company

hirify.global uses proprietary models to automate complex healthcare paperwork, helping patients access care and providers receive payment from insurance companies.

What you will do

• Build and own mappings of payor entities, including parent organizations, subsidiaries, TPAs, PBMs, Medicaid MCOs, and delegated relationships.
• Research and govern medical policies, coverage criteria, government guidance, fee schedules, and clinical content sources.
• Design the logic that determines which entity owns prior-authorization decisions for each plan, product, and service.
• Establish effective dating, provenance, version control, taxonomies, hierarchies, and governance for payor intelligence.
• Map prospect and customer payor data to hirify.global’s model and turn recurring manual work into a repeatable system.
• Drive domain projects from conception to completion while collaborating with engineering, clinical, and operations teams.

Requirements

• 5+ years of experience across the U.S. payor landscape, including Medicare, Medicare Advantage, Medicaid, MCOs, and commercial lines.
• Strong understanding of payor families, subsidiaries, TPAs, PBMs, delegated entities, regional and national plans, and self-funded versus fully insured arrangements.
• Experience interpreting payor policies, government guidance, fee schedules, or clinical guidelines and reconciling conflicting sources.
• Experience building taxonomies, frameworks, databases, or mapping systems used by others.
• Exceptional analytical, investigative, pattern-recognition, communication, and self-directed ownership skills.

Nice to have

• Familiarity with SQL or comparable data tools.

Culture & Benefits

• Remote flexibility with quarterly travel to the Hudson Square office.
• Unlimited paid time off.
• 100% paid employee health benefit options.
• Employer-funded 401(k) match.
• Competitive parental leave.