Senior Director, Operational BI, Data Integrity

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October 17

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Lumeris

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Healthcare Insurance • SaaS

Lumeris is a company focused on providing value-based care solutions within the healthcare industry. With over a decade of leadership in this field, Lumeris partners with health systems to improve patient outcomes and drive financial success through tech-enabled solutions. Their platform supports population health management, clinical delivery transformation, and payer contracting, offering comprehensive solutions for acute, post-acute, and high-risk patient management. Lumeris is recognized for creating significant cost savings and achieving excellent patient outcomes, including a 5-star CMS rating for its Medicare Advantage Prescription Drug Plan.

1001 - 5000 employees

⚕️ Healthcare Insurance

☁️ SaaS

📋 Description

• Lead Operational Business Intelligence and Data Integrity strategy, ensuring alignment with organizational goals and regulatory requirements. • Drive strategic data governance, policies, and practices in coordination with shared services Data Governance, AI Governance, and Analytics teams. • Lead the Organizational and Operational Business Data Intelligence Strategy. • Leverage Sophisticated Business Case methodology to demonstrate clear ROI for proposed and implemented solutions. • 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 product delivery, including but not limited to AI solutioning. • Aligning with Lumeris shared services Data Governance practices, AI Governance, and Data and Analytics teams across the organization. • 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. • Drive accountability for business data content ownership in QA processes. • Partner with Database Administrators (DBAs) to maintain a high performing system that supports the business from a regulatory and operational standpoint. • 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. • Coach, mentor, and develop subordinate leaders and staff to build organizational capacity, deliver results through others, and sustain long-term strategic success.

🎯 Requirements

• Typically requires 15+ years of relevant experience with 7+ years of progressive leadership experience, including demonstrated success influencing at the director level or above. • Degree in Computer Engineering or the equivalent, plus a minimum of 10 years in strategic business data management and development. • Certification/licensure in data management, analytics, or health plan operations a plus. • 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 Regulatory Requirements and Provider/Population Health Hierarchies and the role of data and reporting. • Proven 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. • Experience Interpreting and Designing part C and D Reporting with successful audit results. • Proven experience delivering measurable ROI through automation, BI analytics, and operational efficiency initiatives. • Able to lead through Influence. • Manages multiple tasks, be detail oriented, responsible and show an elevated level of critical thinking. • Strong executive presence, with excellent communication, negotiation, and influencing skills across all levels of the organization. • Proven ability to deliver results through others while balancing strategic innovation and operational execution. • Ability to work well in a fast-paced environment that is undergoing change.

🏖️ Benefits

• Medical, Vision and Dental Plans • Tax-Advantage Savings Accounts (FSA & HSA) • Life Insurance and Disability Insurance • Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) • Employee Assistance Program • 401k with company match • Employee Resource Groups • Employee Discount Program • Learning and Development Opportunities • And much more...