Associate, Healthcare Solutions Data

About the Role

Stout is seeking an Associate, Healthcare Solutions Data – Disputes, Claims & Investigations to join our team.

Key Responsibilities

• Develop and maintain accurate audit tools and pricing calculators to support healthcare consulting and dispute engagements.
• Provide reliable analyses of healthcare pricing, reimbursement, payment activity, and future medical expenses for project teams and expert witnesses.
• Transform complex data and source documents into clear, reproducible calculations, exhibits, and reports.
• Improve analytical efficiency through current reference libraries, documented methodologies, and practical automation.
• Build, maintain, and update audit-tool templates, pricing calculators, and case-specific workbooks to reflect regulatory changes, new publications, data releases, and project needs.
• Perform commercial, Medicare, and Medicaid pricing analyses and fee schedule calculations, clearly explaining assumptions, methods, and results.
• Conduct pre- and post-audit pricing reviews, payment reconciliations, paid/unpaid claim analyses, and reviews of EOB/EOR information and PIP logs.
• Maintain and customize pre-built Excel-based audit tools, including workbooks, data tables, and calculations for individual cases.
• Develop analyses and rebuttal calculations related to future medical expenses when required by an engagement.
• Gather, extract, organize, and analyze data from external systems, source documents, productions, and Medicare Limited Data Set (LDS) files.
• Maintain essential reference libraries, including state pricing files, code descriptions, fee schedules, and related source documentation.
• Apply version control, documentation standards, and data integrity checks to keep analyses accurate, transparent, and reproducible.
• Build custom tools, calculators, and output formats for project teams and outside auditors, including physicians and nurse reviewers.
• Prepare pricing datasets, analytical tables, exhibits, models, report supplements, and summaries for expert reports and testimony.
• Proofread reports and math-check calculations; research applicable regulations, technical interpretations, and opposing analytical positions.
• Explain analytical methods and findings to project teams and expert witnesses and, when necessary, testify on data-driven analyses.

Requirements & Tech Stack

• Spreadsheet and analytical modeling skills: Experience building detailed workbooks, calculators, or audit tools.
• Data analysis: Experience in quantitative analysis involving healthcare pricing, medical claims, reimbursement, or payment data.
• Data management: Experience extracting, organizing, and validating source data and maintaining reference files and version-controlled documentation.
• Research: Ability to research regulatory materials and translate technical findings into accurate exhibits, reports, and explanations.
• Judgment: Sound judgment when handling confidential information, managing competing requests, and developing custom solutions for varied projects.

Qualifications

• Knowledge of healthcare systems: Knowledge of commercial, Medicare, and Medicaid fee schedules, pricing methodologies, and medical code descriptions.
• Reconciliation skills: Ability to reconcile claims and payments, identify data discrepancies, and document clear, defensible calculations.
• Attention to detail: Careful attention to detail, math-checking discipline, problem-solving, and sound judgment across multiple engagements.
• Communication: Ability to communicate complex analyses clearly and work effectively with consultants, attorneys, expert witnesses, clinical reviewers, and other specialists.
• Ownership: Take ownership of your work and embody Stout's core values.

Why Stout?

• Comprehensive Total Rewards program with competitive compensation, benefits, and wellness options.
• Culture of inclusion and respect, embracing diverse perspectives and experiences.
• Investment in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback.
• Flexible work schedules and a discretionary time off policy.

Compensation

• Estimated Range: $74,000.00 - $135,000.00 Annual
• Eligibility for an annual bonus plan.