Program Management Lead Analyst

Job Summary

A company is looking for a Program Management Lead Analyst to support the AAPS program focused on claim accuracy and cost reduction.

Key Responsibilities

• Leverage expertise to identify overpayment cases and develop edit rules
• Oversee edit lifecycles and implement corrective actions as necessary
• Prepare business cases for edits, including financial and operational impact assessments

Qualifications

• Bachelor's degree or higher preferred, or equivalent work experience required
• 3+ years of medical claim processing experience required
• 2+ years of experience with claim systems, particularly Proclaim, Facets, or PMHS required
• Proficiency in Microsoft Office applications preferred
• Ability to work independently with minimal supervision