Tennr Payor Intelligence Sr. Analyst at Tennr builds and owns payor entity mapping and governance for complex U.S. payor data. The role involves translating payor relationships into product requirements and driving projects end-to-end.
Responsibilities
Build and own payor entity mapping: the hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships that define how coverage and authorization actually flow.
Source, interpret, and govern medical policies, coverage criteria, government guidance, and fee schedules, establishing effective dating, provenance, and version control.
Design the delegated-relationship logic behind prior authorization, determining which entity owns the decision for a given plan, product, and service.
Identify and track the clinical content sources our policies depend on, such as InterQual and NCCN, and own what we need to contract for and when.
Map prospect and customer payor data back to Tennr's payor model, turning a recurring manual effort into a repeatable system.
Embrace a founder's mindset, proactively driving projects from conception to completion, and contributing significantly to our company's growth and success.
Candidate Qualifications
5+ years working across the U.S. payor landscape, with real breadth across Medicare, Medicare Advantage, Medicaid and MCOs, and commercial lines of business.
Fluency in payor structure: payor families, subsidiaries, TPAs, PBMs, delegated entities, regional versus national plans, and self-funded versus fully insured arrangements.
Experience researching and interpreting payor policies, government guidance, fee schedules, or clinical guidelines, including reconciling sources that disagree with each other.
A track record of building taxonomies, frameworks, databases, or mapping systems that other people rely on, not just answering questions as they come in.
Exceptional analytical and pattern-recognition skills, with the investigative instinct to work productively from ambiguous and incomplete information.
Qualification
5+ years working across the U
Required
5+ years working across the U.S. payor landscape
Fluency in payor structure including payor families, subsidiaries, TPAs, PBMs, delegated entities, regional vs national plans, and self-funded vs fully insured arrangements
Experience researching and interpreting payor policies
