[Remote] Director | New Product R&D at Machinify

Palo Alto, California, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Strong, hands-on understanding of a Payment Integrity platform (e.g., Cotiviti, Machinify)
Direct experience working with Data Science
Experience with CMS updates (IPPS/OPPS), NCD/LCD, NCCI, state regulations, payer policy trends, provider billing behaviors, and the vendor/competitive landscape
Experience with requirement reviews, design critiques, and readiness checks
Experience conducting trainings and workshops
Experience with defining and measuring OKRs and success metrics

Responsibilities

Lead domain strategy within Product, defining the domain vision and standards for Payment Integrity
Help establish governance for policy/clinical accuracy, model and rule validation, and compliance-by-design
Develop deep expertise in Machinify’s platform capabilities
Partner hands-on with Data Science to define labeling guidance, sampling strategies, and evaluation metrics
Monitor and synthesize market and regulatory intelligence
Deliver concise POVs and impact briefs to inform product prioritization
Bridge SME Operations insights into product decisions
Support cross-functional execution and enablement, overseeing UAT
Measure outcomes and iterate on domain-level OKRs and success metrics
Provide executive-level communication, influence, and stakeholder management

Skills

Machinify

AI-driven solutions for healthcare administration

About Machinify

Machinify provides AI-driven solutions to improve decision-making in the healthcare industry. Its platform helps health plans, payers, and providers optimize their operations, particularly in areas like claims processing and utilization management. The applications offered by Machinify can be quickly deployed, allowing clients to see immediate returns on investment. This focus on rapid implementation sets Machinify apart from competitors, as healthcare organizations increasingly seek cost efficiency and better patient outcomes. The company's goal is to enhance operational efficiency and help clients manage healthcare expenditures more effectively.

Palo Alto, CaliforniaHeadquarters

2016Year Founded

$15.2MTotal Funding

SERIES_ACompany Stage

AI & Machine Learning, HealthcareIndustries

51-200Employees

Benefits

Medical, dental, & vision

Flexible work environment

Generous PTO

Competitive salary

Equity

401(k)

Sponsorship

Generous L&D Reimbursement policy

Risks

Integration challenges with Evolent Health could disrupt Machinify's operations.

Slow adoption of new technologies in healthcare may hinder Machinify's rapid deployment.

Reliance on a few large clients poses a risk if they switch providers.

Differentiation

Machinify leverages AI to optimize healthcare decision-making and administrative processes.

The company offers rapid deployment of AI applications for immediate ROI in healthcare.

Machinify's AI platform addresses the entire healthcare claims lifecycle efficiently.

Upsides

AI-driven automation in healthcare claims processing is gaining significant traction.

The healthcare AI market is projected to reach $45.2 billion by 2026.

Machinify's AI solutions reduce administrative costs and improve patient care access.

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