Rialtic

• Grow and lead a high-performing team of Content Policy Managers and Analysts • Serve as a player-coach, creating an environment of ownership, resilience, and high accountability — without micromanaging • Research potential policy defects and resolve inquiries submitted by clients and colleagues from across the enterprise • Troubleshoot policy defects and collaborate with Content and Engineering teams to adjust and resolve policy design to deliver the intended functionality • Lead root cause analysis (RCA) of identified policy defects to determine additional controls needed to drive E2E continuous quality improvement • Proactively leverage policy utilization trend data to monitor, investigate, and mitigate insight rate anomalies • Leverage the combined policy defect and utilization trend data to identify and develop process changes, automation/tooling enhancements, and scalable, AI-enabled approaches to drive increased efficiency and quality across the E2E Content development process • Partner with Product and Engineering teams to define and drive strategic Content platform enhancements • Maintain a strong sense of speed of play — balancing urgency with quality • Lead the ongoing maintenance of Rialtic’s policy library to ensure policies remain accurate and up-to-date with source changes • Lead the implementation of new CPT, HCPCS, and ICD-10 codes across Rialtic’s policy library • Manage Rialtic’s subscriptions to Content reference sources and serve as vendor relationship manager

• Serve as the SME for outpatient facility editing policy development, leading the research, scoping, and creation of new claims editing policies for the facility capability • Source, interpret, and scope new payment integrity policies to expand Rialtic's claims editing content library from outpatient facility claims • Prioritize policy updates based on savings potential, client impact, and strategic alignment with platform goals • Leverage CMS, Medicaid, clinical guidelines, and industry trends to identify opportunities for new content development for facility claims • Quantify and communicate policy value through data-driven analysis and clear financial impact assessments in the facility space • Work closely with product and engineering teams to ensure client needs inform platform development, building out our facility capability • Collaborate with content leadership to maintain consistency, quality, and relevance across the policy library • Perform investigation of current facility policy defects and unexpected claim outcomes, performing root cause analysis and policy research to identify corrective actions and improve policy accuracy and performance • Serve as the facility payment accuracy SME in client discussions, presenting policy concepts and addressing facility-related questions when needed

• Lead and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans. • Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and success metrics. • Act as a subject-matter expert in claims analytics for complex or high-visibility client implementations. • Oversee large-scale analysis of claims data related to charge capture, reimbursement, underpayment, overpayment, and payment accuracy. • Ensure the delivery of exception-driven, actionable insights that clearly identify systemic versus isolated issues. • Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in reporting and client-facing deliverables. • Guide analyses related to payor reimbursement behavior and trends, RVU productivity and payment alignment, revenue cycle optimization opportunities, and financial performance to benchmarks, goals, and norms. • Partner with GTM and Customer Success teams to support implementations, renewals, and expansion opportunities through analytics insights. • Collaborate with Product and Engineering teams to influence roadmap priorities based on claims analysis findings and client needs. • Serve as a senior analytics representative in client-facing discussions, executive readouts, and strategic reviews. • Guide data ingestion and processing pipelines using SQL*Loader, Oracle, shell scripting, and cloud-based tools. • Oversee advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and AWS.

• Review healthcare policy (Medicaid manuals, fee schedules, CCI, OIG Alerts, LCAs/LCDs, NCDs, Medicare manuals, etc.) for coding and billing guidelines that you will interpret and use data validation to ensure the policy and specs align. • Work with the concept creation team who create billing edits that provide clients with monetary savings and promote coding accuracy, to ensure accuracy and provide feedback on their edits. • Ensure that the structural design follows the policy intent by using data analysis. • Build unit tests to verify the functionality of the edits • Apply revenue cycle, coding, and billing expertise to interpret policy based on correct coding, billing, and auditing guidelines • Provide in-depth research on regulations and support edits with official documents • Validate if edits are working as intended and support decisions with validation data • Maintain current industry knowledge of claim edit references including, but not limited to: AMA, CMS, NCCI • Collaborate with the Content, Engineering & Data teams to develop, adjust, and validate edits • Provide subject matter expertise on several professional claims top error areas in coding and billing across multiple specialties • Independently meet weekly productivity and quality goals • Be a self-starter and remain driven while independently working remotely.

• Review healthcare policies and determine the logics to create based on strategic and technical considerations • Create functional designs and test claims from concept through validation and maintenance • Review, edit and finalize designs and test claims assigned to content analysts • Mentor and coach content analysts on conceptualizing, creating and delivering claims processing edits • Create and manage special projects and programs from concept through execution and maintenance • Troubleshoot edits that do not function as expected and collaborate with Engineering teams • Drive prioritization of drug library • Curating drug edit scoping templates • Partnering with our clinical teams to review & respond to Validation questions • Identify and create business cases for any system enhancements • Partner with our Clinical Leadership on providing content development & maintenance

• You'll own the annual budgeting process and rolling forecasts on a monthly and quarterly basis. • You'll build and maintain comprehensive financial models covering revenue, expenses, headcount, and cash flow. • A critical part of this role involves analyzing performance versus plan and proactively communicating risks and opportunities to leadership. • You'll take ownership of headcount planning and tracking across the entire company. • You'll manage vendor spend, implement cost controls, and drive efficiency initiatives that optimize our resource deployment. • Partnering closely with the Sales team, you'll forecast revenue and analyze the client pipeline to provide visibility into future performance. • You'll support deal sizing, pricing decisions, and margin analysis while continuously working to improve forecast accuracy and visibility across bookings and revenue. • You'll partner with Product and Content teams to understand roadmap priorities and translate them into financial impact. • You'll analyze the ROI of content and product investments. • You'll own the creation of weekly, monthly, and quarterly executive reporting packages. • You'll prepare investor updates and Board of Directors materials. • You'll develop and track key business KPIs that matter most to our success, building dashboards and reports that provide real-time visibility. • You'll provide ad hoc financial analysis for strategic initiatives.

• Source, interpret, and scope new payment integrity policies to expand Rialtic's claims editing content library • Prioritize policy updates based on savings potential, client impact, and strategic alignment with platform goals • Leverage CMS, Medicaid, clinical guidelines, and industry trends to identify opportunities for new content development • Quantify and communicate policy value through data-driven analysis and clear financial impact assessments • Identify adoption gaps, implementation inefficiencies, and emerging opportunities within client programs • Work closely with product and engineering teams to ensure client needs inform platform development • Collaborate with content leadership to maintain consistency, quality, and relevance across the policy library • Serve as the payment integrity expert across enterprise initiatives, providing consultative guidance to internal teams