Job Description
Job Summary:
Develop and oversee enterprise clinical data management strategy and governance activities to optimize payer-provider clinical digital data exchanges for completeness, accuracy, and regulatory compliance while maximizing efficiency and value to Molina Healthcare and our providers. Lead enterprise discovery to inventory Use Cases for bi-directional clinical data exchange and digital transactions across the enterprise. Develop a strategy and a prioritized roadmap for enhanced data capabilities that increase efficiency through technology, create enterprise value, and elevate Molina as a preferred payer partner to providers. This role is also responsible for establishing data policies, standards, and report on key metrics. This leader will collaborate with leadership to align business priorities, budget, and technology innovation related to clinical data management.
Purpose:
This initiative establishes an enterprise-level strategy and governance model to address fragmented payer-to-provider clinical digital data exchanges that no single Molina function can solve independently.
Independent decisions to deploy new capabilities and scale across COE, Quality, Risk, Clinical, UM, Payments/PI, and related teams have resulted in redundant data sources, duplicative provider interactions, avoidable cost, and inconsistent and/or abrasive provider experience. Today, there is no single enterprise forum where a holistic strategy is defined and where data capability roadmap and trade-off decisions are made. As we further expand CDE sources and technologies, such as the Epic Payor Platform, as well as rapidly evolve to digital regulatory mandates, these inefficiencies and issues will only increase without rationalization, on ongoing “living” strategy, and a forum to make enterprise investment decisions.
ObjectivesThe objectives and outcomes of the CDE Strategy Group will be three-fold
- Enterprise Discovery
- Inventory major use cases for bi-directional clinical data and digital transactions across the enterprise - push, pull, chase – to create or amplify value.
- Document industry best practices and trends (including AI), regulatory requirements for digital data and electronic transactions, and provider abrasion factors.
- Evaluate the completeness, accuracy, acquisition efficiency, and cost of each data source.
- Strategy– Develop a strategy and a prioritized roadmap for improvement across data capabilities and functions with associated business cases, which also elevates Molina as a preferred payer partner to providers. Roadmap should address the impact of digital advances on the composition of various staffing, departments, partners in a multi-year roadmap.
- Governance– Establish a governance process for collaborating across the enterprise (business and IT), and for adding new data sources, technologies, and partners.
Knowledge/Skills/Abilities
- Experience product managing clinical data acquisition including EMR and other data source integrations, data source rationalization, business case development, and build-buy decisions
- Manages and leads high-performing, cross-functional teams throughout large-scale data management and governance initiatives; drives a culture of continuous improvement to ensure timely delivery of all commitments.
- Collaborates with enterprise clinical and risk functional areas to enhance or create solutions.
- Analyzes current business practices, processes and procedures, and collaborates with enterprise clinical, risk, and payment functional areas to identify business opportunities and regulatory mandates to enhance or create solutions.
- Ability to understand, synthesize, and communicate complex business requirements into a prioritized solution roadmap.
- Designs and oversees clinical data governance bodies (e.g. steering committee, data councils, etc.) and policies, standards, and KPIs as well as identifies roles and responsibilities.
- Collaborate with IT Leadership to assess and size clinical data solutions to ensure that accurate and complete data is accessible and available to support operations and management decision-making.
- Communicates the business value forecasted and achieved to key stakeholders and reports project statuses and needs to Leadership regularly.
Job Qualifications
Required Education: Bachelor's degree in computer science, data analytics, information technology, or similar field.
Required Experience:10+ years of related clinical data experience.
Preferred Education: Master's or other Graduate degree.
Preferred Experience
- 5+ years of management experience with demonstrated experience in strategic planning and implementation.
- Deep healthcare industry expertise with extensive knowledge of industry best practices.
- Proven history of executing change management and building credibility with key stakeholders to drive organizational change.
- Strong critical-thinking and strategic leadership abilities to achieve ambitious business objectives and goals.
- Highly skilled in planning and delivering multiple critical, complex projects.
- Excellent interpersonal skills to foster relationships across multiple organizations.
- Ability to effectively communicate data governance concepts and principles to non-technical constituents.
- Extensive data management and analytics experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Originally posted on Himalayas