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Payor Data Solutions Lead

Remote, United States
firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.
 
firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.
 
We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
 

 

We are seeking a Payer Data Solutions Lead  to own the end‑to‑end lifecycle of partner data that powers customer success, value creation, and operational execution. This role stewards monthly batching and claims ingestion, manages attribution end to end, and surfaces issues that impact value realization. You will also partner with Customer Success in MORs through clear storytelling, insight packaging, and problem solving with payer partners.
 
The ideal candidate blends technical depth in healthcare data with crisp communication and stakeholder leadership across Product, Data/Engineering, Customer Success, and Payer counterparts.
 
Top Priorities:

 

1. Commercial request intake and MOR support

 

  • What: Triage and deliver on pre‑/post‑sales data asks. Support file onboarding and steady‑state flows end to end. Set clear specs and SLAs, author mappings and test plans, and monitor pipelines into Snowflake so downstream dashboards and SLAs run without interruption. Support MORs.
  • Success: Request backlog cycle time down. On‑time MOR packages. Stakeholder CSAT.
  • Interfaces: Customer Success, Product, Eng, Payer partners.

 

2. End to end attribution management

 

  • What: Run monthly batching and support Eng in claims ingestion. Manage payer data implementations. Monitor and resolve anomalies like unexplained churn or delayed BenSupp rate‑cell transitions, and manage automations for said checks. Define and QA attribution logic. Operate monthly batching and claims ingestion with tight controls, tracking adds/deletes and net attribution changes. Reconcile with payer data teams.
  • Success: Stable net attribution deltas. DQ alerts resolved within SLA. No downstream dashboard breaks.
  • Interfaces: Data Eng, Payer data teams

 

Experience & Skills Requirements:

 

  • 4+ years in Data Product Management, Implementation, or Technical Program Management
  • 4+ years working with healthcare payers or PBMs on data integration projects (claims, eligibility, enrollment, provider, or remit files)
  • Proven experience operating recurring ingestion pipelines and data quality controls in production
  • Strong communicator who can translate between technical and non‑technical stakeholders and craft payer-ready narratives
  • Strong organization and documentation habits with repeatable processes and playbooks
  • Strong working knowledge of SQL, data modeling, and common healthcare file formats (e.g., 837/835/834, custom delimited extracts)
  • Experience with Apache Airflow, DBT, and ETL / ELT tools, and cloud platforms (e.g., AWS, GPC)

 

Bonus Points:

 

  • Experience with BI tools such as Looker, Tableau, Power BI, or QuickSight
  • Experience in value‑based care and payer reporting constructs (e.g., MLR, risk corridors)
  • Experience with eligibility verification/management vendors or mastering member identity across sources

 

Base salary range:

$150,000 - $160,000 USD

We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.

Benefits
For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.

Vaccination Policy
Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law.
New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.
 
Unfortunately, we are not able to offer sponsorship at this time.

 

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