Medical Economics Analyst (Payment Integrity)

Location Address:

Remote OfficeSanta Fe, NM 87501

Compensation Pay Range:

Minimum Offer $87,526.40Maximum Offer $149,032.00Now Hiring: Medical Economics Analyst-Payment Integrity

Summary:

Build your Career. Make a Difference. Presbyterian is hiring a skilled Medical Economics Analyst-Payment Integrity to join our team.Type of Opportunity: Full timeJob Exempt: YesJob is based: Remote Workers New MexicoWork Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities:

The Payment Integrity Medical Economics Analyst plays a critical role in identifying, quantifying, and validating medical cost savings opportunities through deep partnership with the Payment Integrity team. This role combines advanced analytics, claims validation, and financial insight to ensure accuracy of payments, integrity of savings initiatives, and alignment to total cost of care (TCOC) objectives. This individual will leverage enterprise data assets, including claims and provider data, to produce actionable insights, validate recoveries, and support pre- and post-pay integrity initiatives. The role requires strong technical expertise (SQL/SAS), comfort working with large healthcare datasets, and the ability to translate findings into clear financial impact.

Some key responsibilities include:

• Partner closely with Payment Integrity, Operations, and vendor partners (e.g., Cotiviti, Optum) to support pre-pay and post-pay initiatives • Analyze claims data to identify patterns of…