We are seeking a skilled BI Developer to design, develop, and maintain business intelligence, reporting, and analytics solutions for a cloud-based US Healthcare Revenue Cycle Management (RCM) platform.
This role is responsible for transforming complex healthcare and financial data into actionable insights across Claims, Prior Authorization, Scheduling, Coding, Collections, Payments, Denials, and EDI.
The BI Developer will work closely with Product, Engineering, Data Engineering, DBA, AI/ML, RPA, and Compliance teams to deliver secure, scalable, and compliance-ready analytics that support operational efficiency and strategic decision-making.
BI & Analytics Development:
- Design and develop interactive dashboards, reports, and self-service BI solutions for RCM operations and leadership.
- Translate business and product requirements into data models, KPIs, metrics, and visualizations.
- Build analytics covering:
- Claims lifecycle and payer performance
- Denials, AR aging, collections, and cash flow
- Prior authorization turnaround times
- Coding accuracy and revenue leakage
- Operational SLAs and productivity
- Ensure performance, usability, and scalability of BI solutions.
Data Modeling & Semantic Layer:
- Design and maintain dimensional and analytical data models (facts, dimensions, aggregates).
- Create and manage semantic layers to ensure consistent definitions of KPIs and metrics.
- Partner with Data Engineers and DBAs to ensure optimal query performance on SQL Server and Snowflake.
- Validate data accuracy, reconciliation, and lineage across source systems.
Cloud Data & Platform Collaboration:
- Develop BI solutions leveraging cloud data platforms (Snowflake, SQL Server on cloud).
- Optimize BI queries for cloud warehouses and compute resources.
- Work with engineering teams to ensure BI readiness of microservices-generated data.
- Support analytics for real-time, near-real-time, and batch workflows.
RCM, EDI & Operational Reporting:
- Build and maintain reports and dashboards consuming EDI transaction data:
- 837 (Claims), 835 (Payments), 270/271 (Eligibility),
- 276/277 (Claim Status), 278 (Prior Authorization)
- Enable analytics across payer responses, rejections, denials, and remittance data.
- Support operational teams with ad-hoc analysis and root-cause investigations across RCM modules.
AI / Automation & Advanced Analytics Enablement:
- Support AI/ML, GenAI, Agentic AI, and RPA teams by providing curated, analytics-ready datasets.
- Validate outputs from automation and AI-driven workflows using BI and reconciliation reports.
- Enable monitoring dashboards for AI model performance, automation success rates, and exception handling.
Security, Compliance & Data Governance:
- Ensure BI solutions comply with HIPAA, SOC 2, and internal data governance standards.
- Implement role-based access control (RBAC) and PHI masking within BI tools.
- Maintain auditability and traceability of reported metrics.
- Document metric definitions, data sources, and reporting logic.
Stakeholder Collaboration & Enablement:
- Work closely with Product Managers, RCM SMEs, Operations, Finance, and Leadership to understand reporting needs.
- Enable self-service analytics and train business users on dashboards and insights.
- Participate in release planning and ensure analytics readiness for new product features.
- Bachelor’s or Master’s degree in Computer Science, Information Systems, Data Analytics, or related field.
- 5–9+ years of experience in BI development, reporting, and analytics.
- Strong experience working with SQL Server and Snowflake in analytics use cases.
- Hands-on experience with BI and visualization tools in enterprise environments.
- Experience in US Healthcare, RCM, financial systems, or regulated industries is highly preferred.
- Exposure to AI/ML-driven analytics or automation reporting is a plus.
Technical Expertise:
- Databases / Querying: SQL Server, Snowflake, Advanced SQL
- BI & Visualization Tools: Power BI, Tableau, Looker, or equivalent
- Data Modeling: Star schema, snowflake schema, semantic layers
- Cloud Platforms: AWS, Azure, GCP (analytics and security awareness)
- RCM & EDI: 837, 835, 270/271, 276/277, 278 (reporting & analytics)
- Integration Awareness: Microservices, APIs, event-driven data pipelines
- Security & Compliance: HIPAA, SOC 2, RBAC, PHI masking
Skillset:
- Strong analytical and problem-solving skills with a business-first mindset.
- Ability to convert complex healthcare data into clear, actionable insights.
- Strong SQL skills and understanding of performance optimization.
- Excellent communication skills and ability to work with non-technical stakeholders.
- High attention to detail, data accuracy, and compliance.
Strategic Impact:
- Provide real-time and strategic visibility into RCM performance and revenue outcomes.
- Enable data-driven decisions for operations, product, and leadership teams.
- Support AI, automation, and intelligent workflows through trusted analytics.
- Improve financial performance, reduce revenue leakage, and enhance compliance readiness.
Note: At Credence, we uphold the highest standards of integrity in our recruitment process. We do not charge any fees at any stage of the hiring process, and we strictly prohibit any third parties, vendors, or individuals from soliciting money in exchange for job opportunities at Credence.
If you are approached by anyone requesting payment or offering you a position at Credence in exchange for money, do not engage with them. Such actions are fraudulent and not authorized by Credence. Please report any such incidents immediately to our official HR team at [email protected]
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