Vice President, Data Analytics

Job not on LinkedIn

🔥 14 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $176.1k - $251.5k / year

⏰ Full Time

🔴 Lead

📉 Data Analyst

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Lead the development of a scalable claim review intelligence and data mining strategy across Payment Integrity services, including claim audit, pre-pay, post-payment, and provider education. • Establish repeatable routines for medical claim review concept ideation, prioritization, testing, deployment, monitoring, and refinement. • Create and launch new audit and review types that enable organic growth, improve client value, and support new sales opportunities. • Build intelligent processes to balance audit inventory against operational capacity, improving throughput, accuracy, cycle time, and revenue realization. • Design and sponsor tools, workflows, and applications that increase the velocity and volume of claim reviews performed by audit operations. • Establish Provider Education as both a standalone offering and an integrated feature of Payment Integrity delivery. • Partner with analytics, data engineering, technology, and audit operations teams to deliver and govern a centralized rules engine supporting pre-pay and post-payment workflows. • Build Weekly Leading Indicator and Monthly Leading Indicator reporting frameworks that improve revenue predictability, operational visibility, and executive decision-making. • Ensure data engineering and data management processes support scalable growth in reporting, concept development, claim selection, analytics deployment, and delivery. • Partner with implementation and delivery teams to ensure client onboarding and analytics deployment are defect-free, scalable, and aligned to expected revenue outcomes. • Lead cross-functional initiatives that improve claim selection precision, audit yield, auditor productivity, operational quality, and client performance. • Serve as an executive partner to Payment Integrity leadership, translating business growth objectives into actionable analytics, process, reporting, and operational strategies.

🎯 Requirements

• Bachelor’s degree in Business, Healthcare Administration, Analytics, Data Science, Information Systems, Finance, or a related field; advanced degree (MBA/MPH) preferred • Extensive leadership experience in healthcare claims, Payment Integrity, claim audit, data mining, healthcare analytics, payer operations, or related cost containment functions • Demonstrated experience leading enterprise-level analytics, operational transformation, reporting, rules-based workflow, or process improvement initiatives • Strong understanding of medical claims data, payment accuracy concepts, claim review workflows, and healthcare payer operations • Experience developing audit concepts, claim selection strategies, rules-based processes, operational scorecards, executive reporting, or revenue forecasting frameworks • Proven ability to lead cross-functional teams across analytics, operations, technology, implementation, delivery, finance, and business leadership • Strong executive presence with the ability to communicate complex analytic and operational concepts clearly to senior leaders, clients, and technical teams • Track record of improving operational throughput, quality, scalability, revenue realization, and forecast predictability in a growth-oriented environment.

🏖️ Benefits

• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • leadership and technical development academies