Support and maintain internal reference data processes aligned with industry-standard clinical ontologies, including ICD-10, SNOMED CT, LOINC, and RxNorm, ensuring accuracy and currency of code mappings.
Execute data quality monitoring routines to identify, document, and remediate gaps or inconsistencies in healthcare data assets; escalate systemic issues to the Senior Director, Informatics.
Apply and refine clinical normalization techniques to map unstructured and semi-structured clinical information to standardized codified data elements.
Support the evaluation of new data assets for depth, specificity, and quality; support Expert Determination workflow; prepare structured assessments and summaries for leadership review.
Collaborate closely with Data Engineering, Product, and Clinical teams to ensure that data specifications are accurately implemented and downstream data products reflect high-fidelity source data.
Contribute to the development and tracking of Data Quality (DQ) KPIs and benchmarks; generate periodic reporting to inform stakeholder decision-making.
Participate in pipeline modernization initiatives, assisting with the migration of legacy reference tables to modern, scalable terminology service frameworks.
Maintain compliance with Inovalon's policies, procedures and mission statement.
Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position.
Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company.
Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.
We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.
Requirements
Bachelor’s Degree in Arts/Sciences (B.A./B.S.) in Health Informatics, Medical Informatics, Computer Science, Health Information Management, or a related field required
Master’s Degree in Arts/Sciences (M.A./M.S.) in Medical Informatics, Health Informatics, or a related discipline preferred
Relevant professional certifications (e.g., RHIA, CCS, CHDA, or equivalent) a plus.
8+ Years of experience in healthcare data, clinical informatics, or a related field, with direct hands-on experience in clinical ontologies and terminology management (with Bachelor's degree) required or
5+ Years of experience in healthcare data, clinical informatics, or a related field, with direct hands-on experience in clinical ontologies and terminology management (with Master's degree) required
Proficiency with clinical code sets including ICD-10-CM, CPT, HCPCS, SNOMED CT, LOINC, and RxNorm.
Proficiency in SQL for querying, analyzing, and validating large-scale healthcare datasets.
Demonstrated experience with clinical data normalization, including mapping unstructured data to standardized terminologies.
Ability to clearly document findings, prepare summaries, and communicate data quality insights to both technical and non-technical stakeholders.
Ability to manage multiple workstreams and prioritize deliverables in a fast-paced, agile environment.