Senior Manager/ Associate Director - Technology Consulting

Summary

Join Tiger Analytics, a company specializing in AI and analytics solutions for Fortune 100 companies, as a Medicare and Medicaid Domain Expert. You will work closely with clients and business stakeholders to analyze pain points in the Medicare and Medicaid processes, particularly claims management. Your responsibilities include evaluating and recommending AI, analytics, and engineering solutions to address client challenges, providing insights to project teams, and ensuring alignment on effective solutions. You will also assess project deliverables and educate project teams on Medicare/Medicaid domain-specific concepts. This role requires deep domain consulting experience, extensive understanding of the US healthcare and Medicare/Medicaid industry, and strong analytical skills.

Requirements

• 12-15 years of deep domain consulting experience with strong Data Engineering background
• Extensive understanding of US healthcare and Medicare and Medicaid industry and its specific regulations
• Excellent analytical skills to identify potential issues and propose solutions by effectively conveying technical information to diverse teams
• Good understanding of plan offerings (e.g., Medicare Advantage, FFS etc.), coverage, and eligibility for Medicare and Medicaid programs
• Familiarity with HCPCS, CPT, ICD codes, taxonomy codes, state billing guidelines, and fee schedules
• Knowledge of CMS guidelines, ACA, and HIPAA regulations for compliance and data security
• Excellent problem solving and critical thinking skills with diligence
• Experience with managing stakeholder expectations to ensure effective communication and program success
• Ability to stay updated on industry trends and emerging technologies

Responsibilities

• Work closely with clients and business SMEs to analyze pain points in the Medicare and Medicaid processes (with greater focus on claims management) and provide detailed information on business procedures, industry regulations, and user needs
• Evaluate and recommend AI, analytics, software, and engineering use cases to address client challenges with regards to complex business logics and user workflows
• Provide critical insights and guidance to project teams, ensuring that the solution accurately reflects the complexities and nuances of Medicare and Medicaid domain (specifically focused on claims management), when developing products, systems, or processes
• Partner with analytics and technology consulting teams to share insights on key processes, personas, and tools, ensuring alignment on effective solutions
• Assess project deliverables, design documents, and test cases to ensure they align with domain knowledge and industry best practices
• Educate project teams on Medicare/Medicaid domain-specific concepts, jargon, and industry standards. Support the development of capability assets (including documents, demos) for the Medicare & Medicaid LOB within Tiger’s Consulting, DS, and Engineering Practice

Preferred Qualifications

• Masters/Bachelor of Science/Engineering, MBA preferred
• Healthcare certifications preferred

Benefits

• Significant career development opportunities exist as the company grows
• The position offers a unique opportunity to be part of a small, fast-growing, challenging, and entrepreneurial environment, with a high degree of individual responsibility