Business Intelligence and Analytics Manager, Reporting and Data Analytics

Machinify is a healthcare intelligence company delivering an AI-powered platform and expertise to help health plans improve financial outcomes and reduce healthcare costs. The Business Intelligence and Analytics Manager owns client, compliance, and performance reporting across healthcare eligibility and claims programs while writing SQL, building dashboards, investigating discrepancies, and leading reporting analysts.

Responsibilities:

• Own the reporting frameworks and standards that meet client requirements while adhering to client-driven SLAs and timeframes
• Own client compliance reporting, client metrics & dashboard reporting, and ad hoc reporting for reclamation clients and other programs, including 271/835/NCPDP-based reporting and data crosswalks
• Partner with data engineering on pipeline reliability, data quality monitoring, and the upstream changes that quietly break downstream reporting
• Participate in client system file generation, client system reconciliation, and reporting support, including inventory tracking
• Own analytics and data requests plus data crosswalks for CAV and COB clients
• Write and optimize production-grade SQL against large-scale claims datasets, and own the testing, documentation, and version control of the reporting codebase
• Proactively surface anomalies and trends
• Conduct ad hoc research and reporting requests as necessary or requested
• Investigate reporting discrepancies to root cause and know the difference between a real data/process issue and a one-off anomaly or timing consideration
• Turn one-off findings into repeatable checks and monitoring, so the same issue isn't manually rediscovered each month
• Build the crosswalks, joins, and validation logic to support on-going reporting needs
• Monitor client files with a tracking mechanism to ensure successful receipt and ETL processes occur in line with business functions, timeframes and reporting requirements
• Coordinate with counterparts to resolve upstream data issues (rejections, reprocessing, eligibility gaps) that surface in reporting
• Serve as a reporting-side liaison between clients and analysts
• Manage a team of reporting analysts — setting priorities, reviewing work, and unblocking them on the claims and data issues that come up day to day
• Review work quality and provide direct feedback and coaching, not just hands-off delegation
• Own the reporting and data roadmap: what gets built, in what order, when and why

Requirements:

• Bachelor's Degree in Business, Analytics, Healthcare Analytics, or related field or relevant experience
• Management experience with leading, mentoring, or managing others including direct feedback on technical work and handling day-to-day issues (workload, priorities, performance)
• 5+ years in business intelligence, healthcare claims data analysis, or analytics engineering, including time as the most senior analytics person on a team or initiative
• Foundational hands-on experience with eligibility, member and claims data within healthcare analytics and/or claims processing environments
• Deep knowledge of healthcare claims data — claims data, NCPDP, Member & Eligibility files, and standard transaction formats (837/835/271)
• Advanced SQL: you can write, read, debug, and performance-tune complex queries against large claims datasets without assistance
• Hands-on experience within of a modern BI/reporting platform and a cloud data warehouse (Snowflake or comparable)
• Demonstrated success building or overhauling client-facing reporting from an immature or inconsistent foundation
• Business acumen and judgment, excellent written and verbal communication with both internal executives and external clients — able to defend a number, hold ground with evidence, and name uncertainty where it exists
• Proven ability to integrate data across disparate, loosely documented sources and pinpoint the discrepancies that explain reporting inconsistencies
• Comfortable operating with limited structure and ambiguity, prioritizing independently against business goals
• Track record of surfacing and conducting root cause analysis on data-quality or reporting issues