Business Intelligence and Analytics Manager, Reporting and Data Analytics

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

The Healthcare Business Intelligence and Analytics (BIA) Manager owns client reporting, compliance reporting, and performance analytics spanning various programs.  This position will primarily focus on healthcare eligibility and claims datasets. The BIA manager builds and maintains the metrics, dashboards, and recurring reporting that clients and other internal & external stakeholders rely on to understand program performance.

This is a contributor-manager position. Alongside managing your analysts, you will remain hands-on in the data - writing SQL, building reports, and working claims-level detail - while establishing the standards, definitions, and roadmap for the team. You will manage an uneven reporting landscape with data gaps and challenges, across multiple client programs and turn it into quality reporting that can be trusted without revalidation needed.

The right person is comfortable with healthcare claims data (837/835, claims data, Eligibility and Member files, NCPDP), advanced SQL skills, aptitude working with ambiguity, and possessing a can-do, entrepreneurial spirit as we grow and evolve as a team.

What You’ll Do:

Own reporting & data analytics across client programs

• 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

Build and lead the team

• 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

What You Bring:

• 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.

What We Offer:

• Work from anywhere in the US! Machinify is digital-first.

• Top Medical/Dental/Vision offerings

• FSA/HSA

• Tuition reimbursement

• Competitive salary, 401(k) with company match

• Additional health and wellness benefits and perks

• Flexible and trusting environment where you’ll feel empowered to do your best work

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc.

Pay Range: $110,000 - $120,000

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at:  https://www.machinify.com/candidate-privacy-notice/