Operations Data & BI Leader

Cambia Health Solutions; Vancouver (WA); Hybrid; USD 122,000 - 165,000; Full time

Benefits offered by this job

Health insurance

401(k) match

Paid time off

Parental leave

Wellness programs

Job summary

Cambia Health Solutions seeks a Manager Utilization Management to lead Operations Technical Services with a focus on data, reports, and BI. This hybrid role requires 3 days in office across multiple U.S. cities including Vancouver, WA.

You will manage a team, drive strategic analytics, and collaborate with stakeholders to deliver value for members and providers. Ideal candidates bring a decade of experience in data/BI leadership within health insurance operations, plus strong team-building and

Qualifications

• Bachelor's degree in Computer Science, Mathematics, Business Administration, Engineering or a related field
• Minimum 10 years of related professional experience, including minimum 3 years of supervisory/leadership experience, or equivalent combination of appropriate education and experience
• Ability to develop and lead a team including: hiring, goal setting, coaching and development (including employees in multiple locations and remotely).
• Demonstrated competency in resource and project management: budgeting, organizing work, and providing leadership to staff, strategic planning, establishing measures for success, and managing to deliverables.
• Demonstrated understanding and domain expertise within Health Insurance Operational service area(s) to include Customer Service, Claims, Membership, and/or Provider Operations.
• Strong communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues, build consensus among groups of diverse stakeholders, manage strategic partner relationships, and effectively lead and engage internal teams in the fulfillment of roles and responsibilities.
• Knowledge of health plan operations, health plan data sources and structures, and cost containment strategies.
• Demonstrated experience in business process re-engineering or process improvements is desirable.
• Must be able to effectively adapt to rapidly changing technologies and methodologies and apply them to technological and/or business needs.
• Ability to oversee definition and documentation of business requirements with non-technical, business personnel, and translation of those requirements into a technical solution.
• Ability to develop common solutions and acceptable compromises for business users with conflicting Business Intelligence needs.
• Experience in establishing specific deliverables for staff assigned to large scale, complex projects and work.
• Proven ability to motivate teams to achieve defined deliverables and be able to work effectively with internal and external customers.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

Responsibilities

• Handles all management responsibilities including performance reviews, employee development, hiring, coaching, and retention while establishing goals that align with Cambia Operations and holding direct reports accountable for results
• Provides strategic leadership and clear communication to Operations Technical Services teams across multiple locations, facilitating key meetings and organizing workload to ensure efficient, timely completion of assignments
• Leads planning and implementation of Operations technical services strategy by assembling teams, assigning responsibilities, identifying resources, and providing guidance to deliver high-quality, high-availability services
• Partners with Operations stakeholders to identify information needs, consolidate and automate ad-hoc data analysis, and develop reporting and data solutions that comply with all data privacy regulations and policies
• Oversees data services including architecture, transformation, stewardship, and end-user self-service while leading development of data controls for feeds and ETL processes to ensure data integrity and quality
• Collaborates across departments to resolve issues, manage support relationships between Operations teams, Operations BI, and vendors, and craft solution roadmaps for seamless access to information from various reporting, BI, and data discovery tools
• Stays current with medical management programs, cost containment strategies, medical technology, and market conditions while delivering solutions that include requirement analysis, system design, data models, program development, testing, and documentation
• As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.

Skills

Team leadership

BI leadership

Health plan ops

Data quality & privacy

Communication

AI tools experience

Stakeholder mgmt

Process improvement

Adapt to new tech

Education

Bachelor's degree in CS/Math/Business/Engineering

Job description

Cambia Health Solutions seeks a Manager Utilization Management to lead Operations Technical Services with a focus on data, reports, and BI. This hybrid role requires 3 days in office across multiple U.S. cities including Vancouver, WA.

You will manage a team, drive strategic analytics, and collaborate with stakeholders to deliver value for members and providers. Ideal candidates bring a decade of experience in data/BI leadership within health insurance operations, plus strong team-building and