Sr. Director, Ideation Intelligence & Analytics

At Zelis, we Get Stuff Done. So, let’s get to it! A Little About UsZelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview The Senior Director, Ideation Intelligence & Analytics builds and leads the analytical discovery capability that powers innovation across the Payment Integrity (PI) portfolio. Using healthcare claims data, advanced analytics, AI, statistical methods, and deep PI expertise, the role identifies previously unknown or underdeveloped payment accuracy and savings opportunities across all PI solutions. The role is the analytical engine behind ideation, helping to move the organization beyond reporting into discovery-oriented analytics: finding patterns the organization is not already looking for, sizing their potential, and giving business leaders the evidence to decide where deeper concept development is warranted.

What You’ll Do Analytical Opportunity Discovery Build and lead the analytical discovery capability supporting enterprise PI ideation. Apply advanced analytics, statistical methods, AI, anomaly detection, and pattern recognition to claims, provider, billing, reimbursement, clinical, dispute, and operational data to surface opportunities that existing rules and reporting do not reveal. Develop and test hypotheses about payment errors, billing behaviors, and provider patterns, and identify the populations, claim types, providers, services, and codes associated with each opportunity.

Analyze cross-claim, longitudinal, provider-level, and population-level patterns, and establish methods that separate meaningful opportunities from noise and reduce false-positive discovery. Partnership with Concept & Ideation Serve as the primary analytical partner to the Concept & Ideation team, translating findings into clear opportunity hypotheses for clinical, coding, reimbursement, and policy validation. Provide claims examples, population analysis, provider characteristics, and preliminary savings estimates, and continue testing assumptions, exclusions, and targeting during concept development.

Establish analytical readiness criteria for moving an opportunity from exploratory discovery into formal concept development, and track concept outcomes so methods improve over time. Opportunity Sizing & Analytical Validation Develop sizing methods covering addressable claims, frequency, potential savings, and expected yield, and provide the analytical inputs used to prioritize…