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Tennr is building software to streamline the complex insurance authorization and payment workflows that currently delay patient care and provider reimbursement. The company uses proprietary models to automate the tedious paperwork required for providers to get paid by insurance companies.
You will build and own Payor Intelligence at Tennr as a zero-to-one function. The U.S. payor landscape is fragmented and constantly evolving—parent organizations, subsidiaries, TPAs, PBMs, Medicaid MCOs, Medicare Advantage plans, delegated UM vendors, acquisitions, and rebrands create a massive, conflicting dataset. Your job is to make it legible and actionable.
Key responsibilities include:
- Build payor entity mapping: hierarchies, families, subsidiaries, TPAs, PBMs, and delegated relationships that define how coverage and authorization flow
- Source, interpret, and govern medical policies, coverage criteria, government guidance, and fee schedules with effective dating, provenance, and version control
- Design delegated-relationship logic for prior authorization, determining which entity owns decisions for a given plan, product, and service
- Identify and track clinical content sources (InterQual, NCCN) and manage contracting needs
- Map prospect and customer payor data to Tennr's payor model, converting manual effort into repeatable systems
- Drive projects from conception to completion with a founder's mindset
You'll need 5+ years working across the U.S. payor landscape with breadth across Medicare, Medicare Advantage, Medicaid MCOs, and commercial lines. Deep fluency in payor structure, experience researching and reconciling conflicting payor policies and guidelines, and a track record of building taxonomies and mapping systems that others rely on are essential. Strong analytical and pattern-recognition skills, self-directed ownership, exceptional communication, and SQL or comparable data tooling experience are valued.
