Clinical Data Governance Lead - Enterprise Quality & Accreditation - Hybrid

Cigna in; Bloomfield (CT); Hybrid; USD 90,000 - 150,000; Full time

Job summary

An established industry player is seeking a Clinical Data Governance Lead to enhance data integrity and quality within their Enterprise Clinical & Health Organization. This pivotal role involves overseeing data governance initiatives, collaborating with clinical and IT stakeholders, and ensuring compliance with data standards. Ideal candidates will possess extensive experience in healthcare payer operations, strong leadership skills, and a passion for quality improvement. Join a dynamic team that values innovation and excellence, where your contributions will significantly impact healthcare quality and efficiency.

Qualifications

• 7+ years in Data Governance, Data Management, and Quality practices.
• Strong background in healthcare payer data products and processes.

Responsibilities

• Implement data governance practices and serve as primary business contact.
• Lead initiatives aligning data governance with business needs and regulations.

Skills

Data Governance

Data Management

Data Quality

Process Improvement

Healthcare Payer Knowledge

Analytical Skills

Leadership Skills

Communication Skills

Problem-Solving

Agile Methodology

Education

Bachelor's degree

Master's degree

Tools

SQL

SAS

TOAD

Python

Hadoop

Teradata

Databricks

Snowflake

Tableau

Collibra

Job description

Clinical Data Governance Lead - Enterprise Quality & Accreditation - Hybrid (Finance)

Role Summary:
Effective execution of good data governance principles and practices minimizes risk and ensures the data is available and fit for purpose. As part of The Cigna Group's Enterprise Clinical & Health Organization (ECHO), the Clinical Data Governance Lead is responsible for overseeing the integrity, quality, and governance of data critical to ECHO operations, programs, and strategies. Ideal candidates should have strong background on health care payer Clinical operations / programs and related clinical data standards with drive towards business enablement and quality improvement.

Responsibilities:

• Implements data ownership / data stewardship practices and serves as the primary business contact for data-related decisions and accountability to ensure appropriate data use, access, standards, quality, controls, and metadata / knowledge management for Clinical data and data assets.
• Leads Data Governance initiatives and collaborations with Clinical business and IT operational stakeholders to:
  
  • Set data governance priorities based on business operational needs and regulatory / market demands
  • Work closely with business and technology partners to implement data governance priorities / requirements
  • Continuously improves and enhances data governance best practices for the organization
• Implements Operational Data Governance, controls, and risk management as 1st Line of Defense
• Partners closely with Enterprise Data Governance and Data Stewards to align / implement enterprise data standards and data governance best practices and support 2nd Line of Defense data governance oversight, standards, and monitoring at the enterprise level as well as 3rd Line of Defense activities with Internal and External Audit parties as required.

Qualifications:

• Bachelor's degree or higher
• 7+ years professional work experience in:
  
  • Data Governance, Data Management, Data Quality, or Process Improvement practices
  • Healthcare payer data products and processes
  • Clinical data standards and operations, including:
    
    • Clinical terminology, concepts, business processes and data management lifecycle related to Health Services, Care Management, and Health / Wellness programs (e.g., utilization management, case management, demand management, medical review, care plans, health care coaching, incentives, etc.)
    • Health Profiles / History (e.g., health assessments, electronic medical records, etc.)
    • Health Measurement (population health, evidence-based medicine, episodes of care, gaps in care, health risk scores, next best actions, HEDIS, NCQA, performance guarantees, etc.)
    • Clinical operational source systems (e.g., TruCare, Evicore, MDLive, etc.) and related operational / analytic reporting systems
    • Healthcare Interoperability, HIE / EDI data exchange, and EMR standards and solutions (e.g., HL7, FHIR, OHDSI / OMOP, Epic, Arcadia, etc.)
• Strong communications skills (verbal, listening, written, and presentation) with management teams and peer groups
• Strong leadership skills to motivate others to achieve goals and inspire change; ability to engage business and data stakeholders to resolve questions or issues; demonstrate ability to create professional relationships and effectively influence cross-functional teams
• Must have the ability to manage multiple and sometimes competing priorities in a fast-paced environment; ability to organize and develop project plans supporting near and long-range goals and actions; able to strategize across complex, cross-functional projects and initiatives
• Must have strong analytical and problem-solving capabilities
• Must be able to think creatively, innovate and flex where needed - quick/adaptive learner and collaborator/team player
• Self-motivated and able to function with minimal direction
• Intermediate to Advanced proficiency in the implementation and management of data analysis and data governance tools / solutions (e.g., SQL, SAS, TOAD, Python, Hadoop, Teradata, Databricks, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.)
• Project management and Six Sigma skills are a plus
• Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.)