Clinical Analyst

Job overview

The Clinical Analyst role is remote in the United States. Compensation is not specified. Lyric develops healthcare decision-intelligence solutions that combine clinical, payment, regulatory, and policy expertise with AI to support health-plan claims workflows. The analyst develops clinical policies and payment solutions by evaluating evidence, claims data, and clinical criteria. The role translates policy requirements into rules and clinical content that support transparent, accurate coverage and reimbursement decisions.

What you'll do

• Use claims analytics to identify opportunities for coverage criteria and claim edits
• evaluate medical literature for evidence-based policy development
• draft, review, and maintain coverage criteria
• present proposed criteria to peers and leadership
• recommend and program claim-denial rules based on written policies
• enter clinical content into internal tools and databases
• support customers with clinical content in collaboration with Customer Operations.

What we're looking for

Skills & competencies

clinical analyst

clinical policy

claims analytics

payment integrity

coverage criteria

medical literature

healthcare decision intelligence

remote us

lyric

no visa sponsorship

Work arrangement

• Weekend coverage required

Why this role

Requires a bachelor's degree in biology, nursing, health sciences, or a related field and five years of experience in one or more listed clinical, research, utilization, payment-integrity, revenue-cycle, product, market-access, or medical-writing areas. Applicants must already be authorized to work in the United States; sponsorship is unavailable.

About the employer

Lyric is hiring for this role. Industry: Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services. Sector: 51.