Job title
Senior Director Ideation Analytics Data Mining

About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25, 000 employees across 5 countries.

Senior Director/ Principal Consultants drive innovation within payment integrity analytics by designing new detection frameworks and managing algorithm portfolios. The role strongly influences the Creation and Impact phases of the Sagility Payment Integrity Solutions.

Job title:

Senior Director Ideation Analytics Data Mining

Job Description:

Principal Consultant I/ Senior Director – Ideation & Analytics (Data Mining)
Role Summary

Senior Director/ Principal Consultants drive innovation within payment integrity analytics by designing new detection frameworks and managing algorithm portfolios. The role strongly influences the Creation and Impact phases of the Sagility Payment Integrity Solutions.
Key Responsibilities
Discovery

• Identify strategic opportunities for payment integrity innovation.
  
• Lead cross-functional discovery initiatives.
  

Creation

• Design enterprise-scale detection algorithms.
  
• Build algorithm libraries across clinical, coding, and pricing leakage areas.
  
• Develop advanced predictive analytics models.
  

Impact

• Manage analytics portfolio delivering significant financial recoveries.
  
• Collaborate with PI operations leaders and client stakeholders.
  
• Drive innovation within PI analytics methodology.
  

Mandatory Skills

• Advanced PI analytics expertise
  
• Algorithm portfolio design
  
• Healthcare payer economics
  

Preferred Skills

• AI-driven analytics
  
• Predictive modeling
  
• Healthcare reimbursement modeling
  

Experience

10–15 years in healthcare analytics or payment integrity.

Location:

Work@Home USAUnited States of America