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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 Dat