Product SME – Denial Management & Data Analytics

About  IKS Health  www.ikshealth.com

IKS Health takes on the chores of healthcare, reducing administrative, clinical, and operational burdens so that staff can focus on their core purpose: delivering exceptional care. Combining pragmatic technology and dedicated experts, IKS enables stronger, financially sustainable enterprises. Our Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality, and achieve cost savings through forward-thinking solutions. Founded in 2006, IKS Health’s global workforce supports large health systems across the United States.

Role Overview

50% travel is required

The Product SME – Denial Management & Data Analytics is a techno-functional healthcare expert who specializes in optimizing revenue cycle performance through data-driven insights, automation, and intelligent denial prevention.

This individual will partner with clients to translate their revenue cycle and denial workflows into best-practice designs within our product ecosystem — leveraging analytics, rules, and automation to reduce avoidable denials, accelerate reimbursements, and improve financial outcomes.

Core ResponsibilitiesClient Process Assessment & Mapping

Engage with revenue cycle and finance stakeholders to understand existing denial management processes, data flows, and key performance drivers.

Conduct detailed assessments of current denial root causes, resolution workflows, and reporting capabilities.

Map current-state workflows to the target product environment, identifying opportunities for automation and predictive analytics.

Solution Design & Advisory

Design best-practice denial management processes leveraging product capabilities such as denial categorization, rules engines, workflow automation, and AI-driven insights.

Define key metrics, dashboards, and reports to track denial trends and root-cause performance.

Recommend data governance and reporting frameworks to ensure transparency and actionable intelligence.

Requirements Translation & Validation

Translate business, operational, and analytical requirements into clear functional specifications for implementation teams.

Validate configuration of rules, workflows, and dashboards to ensure alignment with intended design and KPIs.

Serve as the “voice of the product” and “voice of the customer” in discussions with analytics, product, and client stakeholders.

Product Expertise & Enablement

Maintain expert-level knowledge of product features related to denial management, workflow automation, and data analytics.

Advise clients and internal teams on how to leverage predictive models, dashboards, and trend analyses to improve performance.

Support enablement and training efforts for internal and client teams on data interpretation and actionability.

Customer Guidance & Change Management

Help clients visualize a data-driven approach to denial prevention and revenue protection.

Partner with operational leaders to define new performance management and accountability processes.

Support change management efforts to drive adoption of analytics tools and proactive denial resolution workflows.

Collaboration & Alignment

Collaborate closely with Product Managers and Data Science teams to share client feedback and shape product enhancements.

Partner with Implementation and Integration teams to ensure accurate data flow across systems.

Support Sales and Pre-Sales teams by articulating the business value and ROI of analytics-driven denial management.

Quality Assurance & Acceptance

Review test results and validation reports to ensure denial rules, dashboards, and analytics deliver the expected insights.

Support User Acceptance Testing (UAT) and sign off on analytical accuracy and workflow integrity prior to go-live.

Key Deliverables

Current vs. future state denial and analytics process maps

Solution blueprints for workflow and data architecture

Denial rules, metrics, and dashboard definitions

Gap analysis and feasibility assessments

Reporting and analytics enablement materials

Post-implementation optimization and insights reports

Key Skills & Attributes

Deep expertise in denial management, revenue cycle analytics, and operational performance optimization

Exceptional analytical, mathematical, and data interpretation capabilities

Strong critical thinking and structured problem-solving mindset

Excellent project management and stakeholder communication skills

Ability to influence, inspire, and lead through ambiguity

Detail-oriented with a passion for process improvement and data accuracy

Skilled at bridging business operations and data analytics teams

Comfort working in a fast-paced, high-accountability environment

Success Attributes

Proven ability to improve denial rates and financial performance through product optimization

Strong storytelling skills with data — able to translate analytics into operational action

Trusted advisor to clients and internal teams for revenue integrity and performance improvement

Track record of delivering measurable outcomes and scalable best practices

Qualifications

Experience: 7+ years in revenue cycle operations, analytics, or healthcare technology, with focus on denial management, claims, or performance analytics.

Implementation Expertise: Experience configuring or implementing denial management or analytics tools (e.g., Epic Resolute, nThrive, FinThrive, Waystar, Change Healthcare, MedeAnalytics, or equivalent).

Technical Acumen:Familiarity with claims data standards (ANSI 837/835), payer denial codes, and root-cause analytics.

Proficiency in data visualization and analytics platforms (e.g., Tableau, Power BI, Looker).

Understanding of data pipelines, reporting logic, and quality assurance principles.

Education: 

Bachelor’s degree in Healthcare Administration, Informatics, Computer Science, Statistics, or related field (Master’s preferred).

Compensation and Benefits: The base salary range for this position is $ $90,000-$125,000 a year. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. IKS Health offers a competitive benefits package, including healthcare, 401 (k), and paid time off (all benefits are subject to eligibility requirements for full-time employees). IKS Health is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

Qualifications Education Required Bachelors or better. Bachelors or better. Bachelors or better. Bachelors or better. Preferred Masters or better. Masters or better. Masters or better. Masters or better. Experience Required techno-functional healthcare expert who specializes in optimizing revenue cycle performance through data-driven insights, automation, and intelligent denial prevention. Technical Acumen: Familiarity with claims data standards (ANSI 837/835), payer denial codes, and root-cause analytics. Implementation Expertise: Experience configuring or implementing denial management or analytics tools (e.g., Epic Resolute, nThrive, FinThrive, Waystar, Change Healthcare, MedeAnalytics, or equivalent). Experience in revenue cycle operations, analytics, or healthcare technology, with a focus on denial management, claims, or performance analytics. Equal Opportunity Employer
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