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Position:Vice President, Operational Business Intelligence and Data Integrity

Position Summary:Strengthen the organization’s ability to make timely, data driven decisions. You will build foundational data integrity in support of accurate and actionable internal and external reporting and analytics. As a leader with deep and broad health plan and value-based care expertise, this role works across multiple functional areas to drive data governance and integrity, implementing and overseeing data management and migration structure and process to supports the business, driving leading edge core competencies in internal and client facing business insights.
This role resides in the business, and holds expertise in both business and technical functions, optimizing skill sets and efficiencies through clarification of business needs, translating them into technically sound business requirements that supports the reporting and technical teams in delivering at the top of their license.
Success is measured through the ability to rapidly scale and grow through systemic efficiencies. Leveraging a history of infrastructure building that drives efficiency and supports new business opportunities, this role establishes documented, repeatable processes that stand up to rigorous audit. This role ensures that all regulatory and operational reporting is sound and accurate, with change control and data governance.
Serving as a key link between business strategy, technical, and reporting and analytics teams, incorporates data confidence into core capabilities all new business strategies, regulatory guidelines, and technical documentation into a well-established and rapidly growing organization. With deep understanding of the nuances of provider, member, clinical, claims and financial data and their revenue, margin and reputational implications, this individual prevents rework and increase the reliability of our data.

Job Description:

Primary Responsibilities

Lead the Operational Data Integrity and BI Strategy.Establish structure and process for alignment of all data migration and mapping work to optimize scalability and reliability, reducing financial and reputational risk.Leverage Sophisticated Business Case methodology to demonstrate clear ROI for proposed and implemented solutions. Identify and execute opportunities to leverage data as an asset to drive revenue and/or reduce operational and medical expenses.Drive accountability for business data content ownership in QA processes that supports and informs technical QA workflows and controls.As a link between the Executive Leaders, Business Operations, Compliance, and Information Systems, meet operational efficiency, CMS reporting, and financial forecasting needs by eliciting detailed and strategic business requirements, leveraging health plan data and business expertise, to ensure reporting teams are equipped with clear technical business requirements.  Through process improvement methodologies, identify opportunities and recommend solutions to simplify and automate process and plan aligned data product delivery.Establish structure and process to support shared services Reporting & Analytics team in efficiently delivering services for the health plan, supporting alignment of operational, financial forecasting and IBNR and CMS Part C&D Reporting.Align with Lumeris leadership for foundational data excellence.In conjunction with Operations, Product, Sales, Network, Finance and IS, develop approved business rules and algorithms that ensure operating systems are designed/built/configured to allow for modularity, reporting, consistency, and clarity.In collaboration with IS, develop policies and documented reporting requirements to maintain a high level of data fidelity as data moves throughout enterprise, ensuring business processes and reporting practices leverage and support this fidelity.Partner with Database Administrators (DBAs) to maintain a high performing system that supports the business from a regulatory and operational standpoint.As appropriate, partner with IS and enterprise reporting project team to define business requirements for a future state of the Data Warehouse to close existing gaps and ensure scalability for operations.Foster an environment of innovation and execution utilizing data management best practices.Create, communicate, and implement policies and procedures to drive the department’s vision, mission and operational data and analytics direction.Proactively identify technical capability deficits in the business operations team and provide training and testing for consistency.

Qualifications

Education:

Degree in Computer Engineering or the equivalent, plus a minimum of 10+ years in strategic business data management and development.

Experience:

10+ years leading a Business Analytics Strategy, Operational Business Intelligence Strategy or Data Management division with 5+ years in Health Plan Sector.Demonstrated understanding of Value Based Care and the role of data and reportingProven success working across multiple functional areas within an organization to successfully incorporate new business strategy, regulatory guidelines and technical documentation to grow and scale a well-established and rapidly growing organization.Evidence of clear ROI recovered from  data focused business initiativesExperience Interpreting and Designing part C and D Reporting with successful audit results.Evidence of Measurable ROI from automation, BI or efficiency work.Able to lead through Influence. Manages multiple tasks, be detail oriented, responsible and show a high level of critical thinking.Excellent communication skills (verbal/written/technical documentation), organizational and interpersonal skills.Ability to work well in a fast-paced environment that is undergoing change.Telework available; Some travel required.

Working Conditions

While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

#LI-Remote

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

$203,000.00-$295,250.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.

Member Facing Position: No- Not Member or Patient Facing Position

Location:Remote, USA

Time Type:Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.