Lumeris · 21 hours ago
Sr. Director, Operational BI and Data Integrity
United States
Full-time
Remote
Director/Executive
$175K/yr - $249K/yr
15+ years expLumeris is a company focused on transforming the healthcare industry by empowering its team members. The Sr. Director of Operational Business Intelligence and Data Integrity will lead efforts to ensure data integrity and governance, supporting strategic decisions for the Medicare Advantage health plan through accurate reporting and analytics.
ConsultingHealth CareInformation Technology
Responsibilities
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
Qualification
Required
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
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
Preferred
Certification/licensure in data management, analytics, or health plan operations a plus
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...
Company
Lumeris
Lumeris is an accountable care delivery innovation company that offers operational support, technology, and consulting services.. It is a sub-organization of Essence Group Holdings.
1001-5000 employees
H1B Sponsorship
Lumeris has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (8)
2024 (13)
2023 (9)
Funding
Current Stage
Late StageTotal Funding
$325.26MKey Investors
Deerfield
2024-04-10Series A· $100M
2023-11-06Debt Financing· $50M
2016-04-01Series Unknown· $80M
Leadership Team
Julie Hammes
SVP of People & Culture
David Carmouche
Executive VP and Chief Clinical Transformation Officer
Recent News
2025-11-05
Company data provided by crunchbase