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ClarisHealth

Payment integrity platform for health plans

Ideation Manager

Business OperationsConfirmed live in the last 24 hours
Full-timeFranklin, TN, USANo salary listedRemote

About the Job

Requirements

  • At least 5 years of experience in healthcare.
  • At least 3 years within Payment Integrity, claims operations, healthcare analytics, or a closely related function.
  • At least 3 years of direct people-management experience with accountability for employee performance, coaching, development, and engagement.
  • Demonstrated experience leading teams through organizational, process, or technology-enabled change.
  • Experience with medical claims, coding guidelines, reimbursement methodologies, provider data, and healthcare policy.
  • Experience using data and analysis to identify payment issues, validate opportunities, determine root causes, and support solution development.
  • Demonstrated experience working across highly collaborative, cross-functional environments and building strong partnerships with multiple stakeholder groups.
  • Experience establishing or improving team processes, standards, or operating practices.
  • Experience leading or supporting process improvement, AI adoption, automation, or technology-enabled transformation efforts.
  • Working knowledge of healthcare claims, provider billing, reimbursement, coding, policy, and payment accuracy concepts.
  • Proven ability to manage priorities, balance team workloads, and deliver results in a matrixed environment.

Responsibilities

  • Lead and develop a team of Concept Ideation Analysts through performance management, regular coaching, career development, talent planning, employee engagement, and recognition; establish clear expectations and an inclusive, accountable, high-performing team culture.
  • Assess current and future capability needs, identify skill gaps, develop growth plans, and create opportunities that strengthen Payment Integrity and business analysis expertise across the team.
  • Apply Payment Integrity expertise, including knowledge of healthcare claims, reimbursement, coding, policy, provider billing, and payment integrity methodologies, to guide analysis, challenge assumptions, assess concept opportunities, and support accurate, actionable recommendations.
  • Translate complex business needs, analysis findings, and strategic priorities into clear messages for leadership, clients, and team members.
  • Balance team capacity, prioritize work, and align resources to meet department objectives and evolving business needs.
  • Establish and reinforce standard business practices, tools, and processes that improve quality, efficiency, and collaboration, reduce manual effort, and modernize team operations.
  • Lead the evaluation and adoption of AI-enabled tools, automation opportunities, and more efficient ways of working to improve productivity, reduce rework, and support scalable delivery.
  • Develop trusted client partnerships and present updates, recommendations, and team insights with confidence and professionalism.

Desired Qualifications

  • Experience leading multidisciplinary Payment Integrity teams.
  • Experience with prepayment and post-payment concept development.
  • Knowledge of the end-to-end concept development lifecycle.
  • Exposure to continuous improvement initiatives and emerging tools such as AI or automation solutions.

About the Company

ClarisHealth

Payment integrity platform for health plans

ClarisHealth provides payment integrity solutions for health plans, anchored by its Pareo platform. Pareo helps health plans maximize medical savings and reduce costs by letting them select and operationalize the best mix of internal and vendor analytics, achieving value at the lowest possible cost. The platform enables rapid, customizable deployments that address each client’s needs, including customizing workflows, data connections, and analytics, along with services for implementation, customization, and support. Compared with generic software, ClarisHealth differentiates itself through highly customizable, fast-implementing analytics-driven solutions tailored to pay-and-claims integrity, real-time business insights, and proactive stakeholder engagement to root out overpayments. The company’s goal is to lower overpayments and improve productivity for health plans by delivering measurable savings and clearer insights through Pareo.

Company size
51-200
Company stage
Debt Financing
Total funding
$4M
Headquarters
Franklin, TN
Founded
2013

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