Lead Director – Informatics Reporting

This is a fully remote position, open to applicants in Connecticut.

📋 Description

• Develop and implement the data and reporting strategy for the Grievances & Appeals division.

• Oversee and enhance informatics reporting processes, systems, and strategies.

• Drive the creation and execution of reporting strategies that align with organizational objectives.

• Supervise the selection, implementation, and maintenance of reporting systems, schedules, and infrastructure.

• Assess and recommend reporting tools, databases, and platforms.

• Identify stakeholders' reporting needs, craft meaningful visualizations, and guarantee data accuracy and consistency.

• Establish and uphold reporting governance frameworks, policies, and procedures.

• Enhance reporting efficiency, accuracy, and usability through automation, data visualization, and self-service reporting options.

• Set performance metrics and reporting mechanisms.

• Connect IT delivery, enterprise analytics, and clinical/operational leadership for risk management and regulatory compliance.

• Lead teams in analyzing Grievances & Appeals data and generating actionable insights related to appeals, grievances, root causes, regulatory performance, and productivity.

• Ensure compliance with healthcare regulations and audit requirements.

• Safeguard data integrity, traceability, and auditability.

• Develop internal informatics and analytics capabilities, scalable operating models, reusable data assets, and self-service solutions.

• Promote continuous improvement through automation and standardization efforts.

• Define job functions and clarify roles within the informatics team.

• Lead, mentor, and nurture analytics and reporting talent.

• Employ healthcare expertise in claims, grievances, authorization, appeals, lifecycle management, and compliance tracking.

⛳️ Requirements

• Over 10 years of experience in informatics, analytics, or business intelligence.

• Strong background in the healthcare domain, preferably in claims, grievances, authorization, and appeals.

• Proven leadership in data strategy, reporting, and team development.

• Bachelor’s degree is mandatory.

• Experience with the Aetna EDP platform is preferred.

• Familiarity with GCP, including BigQuery and Looker/Cloud is preferred.

• Experience integrating AI technologies into reporting processes is preferred.

• Proficient with tools such as Coginiti, Dataiku, Tableau, Power BI, SAP reporting tools, and Quick Base is preferred.

• Knowledge of Agile SDLC is preferred.

• Proficient in Microsoft Office applications, including PowerPoint, Excel, Word, and SharePoint.

• Experience collaborating with executive leadership.

• Proven track record in identifying and implementing process improvements.

• Experience in leading analytics teams and translating requirements into actionable solutions.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base pay.

• Award target in the company’s equity award program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.