Business Analyst, Clinical & Reimbursement Policy

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Business Analyst, Clinical & Reimbursement Policy based in the United States. The Business Analyst, Clinical & Reimbursement Policy will help transform complex healthcare regulations into accurate, automated, and scalable claims processes. This remote role combines deep Medicare Advantage expertise, policy management, data analysis, and emerging AI technologies to strengthen payment accuracy and regulatory compliance. You will oversee the full lifecycle of clinical and reimbursement policies, ensuring they remain current, correctly interpreted, and consistently implemented across claims systems. Acting as a subject matter expert, you will collaborate with Clinical, Claims, Compliance, Configuration, and Data Science teams to translate regulatory guidance into actionable technical requirements. You will also manage external vendor performance and leverage advanced AI tools to automate policy monitoring and regulatory research. This opportunity is ideal for a detail-oriented, forward-thinking professional passionate about improving healthcare operations through technology, automation, and data-driven decision-making.