We are seeking a BI Manager / BI Lead to own, scale, and automate the Business Intelligence function for a cloud-native US Healthcare Revenue Cycle Management (RCM) platform.
This hybrid hands-on + leadership role combines BI architecture, Power BI development, automation via Power Automate, and analytics strategy.
The role will drive integrated, action-oriented analytics across Claims, Prior Authorization, Scheduling, Coding, Collections, Payments, Denials, AR, and EDI, enabling real-time insights, automated alerts, and embedded analytics across the platform.
You will collaborate closely with Product, Engineering, Data Engineering, DBA, AI/ML, RPA, DevOps, Compliance, and Operations teams to deliver secure, scalable, and compliance-ready analytics.
BI Strategy, Ownership & Roadmap:
- Define and own the BI, analytics, and reporting roadmap aligned with RCM product and business outcomes.
- Establish standardized analytics with AI Insights KPIs, metrics, and dashboards across the full RCM lifecycle.
- Drive adoption of actionable analytics through alerts, workflows, and embedded dashboards.
- Act as the analytics owner and escalation point for the RCM platform.
Hands-On BI Development & Power BI Leadership:
- Design and develop Power BI dashboards, reports, and semantic models for:
- Operations, leadership, finance, and product teams
- External customers (embedded or shared analytics where applicable)
- Implement Power BI integrations, including:
- Embedded Power BI dashboards in applications and portals
- Secure data access via APIs and service principals
- Row-level security (RLS) and tenant-level governance
- Write and optimize advanced SQL queries on SQL Server and Snowflake.
- Review and guide BI developers on best practices for performance, usability, and governance.
Automation, Alerts & Power Platform Enablement:
- Design and implement Power Automate workflows for:
- KPI-based alerts and notifications
- Exception handling (e.g., claim rejections, denials spikes, SLA breaches)
- Automated report distribution and approvals
- Integrate Power BI insights with email, Teams, ticketing systems, CRM, and operational tools.
- Enable closed-loop analytics, where insights trigger workflows and operational actions.
- Collaborate with RPA teams to align Power Automate and enterprise RPA strategies.
Data Modeling, Semantic Layer & Analytics Architecture:
- Lead dimensional and analytical data modeling (facts, dimensions, aggregates).
- Own the semantic layer to ensure consistent KPI definitions and business logic.
- Partner with Data Engineering and DBA teams to ensure:
- Analytics-ready data pipelines
- Optimized Snowflake warehouse usage
- Scalable and cost-efficient analytics architecture
- Ensure analytics support real-time, near-real-time, and batch data flows.
RCM, EDI & Operational Intelligence:
- Own BI and analytics across end-to-end RCM workflows, including:
- Claims submission, rejections, denials, and payments, AR aging, collections, and cash posting
- Prior authorization turnaround times
- Payer performance, SLAs, and contract analytics
- Lead analytics and dashboards consuming EDI transaction data:
- 837, 835, 270/271, 276/277, 278
- Enable root-cause analysis for revenue leakage, payer issues, and operational inefficiencies.
AI, Automation & Advanced Analytics Enablement:
- Partner with AI/ML, GenAI, Agentic AI, and RPA teams to:
- Define success metrics and monitoring dashboards for AI-driven workflows
- Provide curated datasets for model validation and performance tracking
- Build dashboards tracking:
- AI prediction accuracy and drift
- Automation success rates and exceptions
- Ensure analytics supports explainability, trust, and human-in-the-loop processes.
Security, Compliance & Governance
- Ensure BI and Power Platform solutions comply with HIPAA, SOC 2, and internal security standards.
- Implement Row-Level Security (RLS), PHI masking, RBAC, and least-privilege access.
- Maintain audit-ready documentation for dashboards, metrics, and workflows.
- Partner with Compliance and Security teams during audits and customer reviews.
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.
Team Leadership & Delivery Management:
- Lead and mentor a team of BI Developers and Analysts.
- Establish BI development standards, review processes, and quality benchmarks.
- Manage sprint planning, delivery timelines, and stakeholder expectations.
- Act as the final escalation point for BI-related issues.
Stakeholder Engagement & Enablement:
- Serve as the primary analytics partner for Product, Operations, Finance, and Leadership.
- Enable self-service analytics and Power BI adoption across teams.
- Communicate insights through dashboards, alerts, and data storytelling.
Experience:
- Bachelor’s or Master’s degree in Computer Science, Information Systems, Data Analytics, or related field.
- 8–12+ years of experience in BI, analytics, or data roles, with 3+ years in a lead or manager role.
- Strong hands-on experience with Power BI, SQL Server, and Snowflake.
- Proven experience integrating Power BI with enterprise applications and workflows.
- Experience in US Healthcare, RCM, or other regulated domains preferred.
- Exposure to Power Automate, RPA, or AI-driven analytics is a strong 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 leadership with deep hands-on BI and automation expertise.
Ability to connect analytics automation- business outcomes.
- Excellent stakeholder management and communication skills.
- Strong problem-solving ability in complex, distributed systems.
- Compliance-first mindset with a focus on trust and accuracy.
Strategic Impact:
- Transform BI from static reporting to action-driven intelligence.
- Enable real-time visibility and automated responses across RCM workflows.
- Support AI, automation, and intelligent operations with measurable insights.
- Reduce revenue leakage, improve collections, and enhance payer transparency.
- Strengthen audit readiness and customer confidence.
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]
Your safety and trust are important to us. Thank you for helping us maintain a fair and transparent hiring environment.
