Payor Intelligence Sr. Analyst
About the role
Senior analyst role focused on building and governing payor intelligence for Tennr, turning fragmented payor data into durable taxonomies, hierarchies, and governance to enable product, engineering, clinical, and operations teams.
Responsibilities
- Build and own payor entity mapping: hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships that define how coverage and authorization 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.
Qualifications
- 5+ years working across the U.S. payor landscape, with 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 vs national plans, and self-funded vs fully insured arrangements.
- Experience researching and interpreting payor policies, government guidance, fee schedules, or clinical guidelines, including reconciling conflicting sources.
- Track record of building taxonomies, frameworks, databases, or mapping systems that others rely on.
- Exceptional analytical and pattern-recognition skills, with ability to work from ambiguous and incomplete information.
- Self-directed ownership of a domain end to end, without predefined process.
- Outstanding communication skills capable of articulating complex payor concepts to diverse audiences.
- Familiarity with SQL or comparable data tooling is a plus.
Skills
Benefits
- Remote Flexibility
- Unlimited PTO
- 100% paid employee health benefit options
- Employer funded 401(k) match
- Competitive parental leave
About Tennr
Fast, Transparent Patient Experiences
Tennr is solving the black hole problem in healthcare by leveraging models to digitize the flow of paperwork between healthcare providers. -- Today, when you go to your doctor and need to be referred to a specialist (e.g., for sleep apnea), your doctor sends a fax (yes, in 2024, 90% of provider-provider communication is a 1980s fax). These are often converted into 20+ page PDFs, with handwritten (doctor’s handwriting!) notes, in thousands of different formats. The problem is so complex that a person has to read it, type it up, and manually enter your information. Tennr built RaeLM™ (7B—trained on 3M+ documents) to read these docs, talk to your doc to ensure nothing is missed, and text you to help schedule your appointment so you can get better, faster.
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