Exec. Director, Healthcare Benefits Data Engineering

Job Description
CVS Heath/Aetna, a healthcare innovation company, is committed to providing Individuals, Employers, Healthcare professionals, producers and others with innovative benefits, products and services. Effective and agile data and analytic support is critical to delivering on these commitments to Individuals, Employers, and Healthcare professionals, and it depends on a deep understanding healthcare benefits (Insurance) data domains, Data strategy and engineering approaches, Descriptive KPI and reporting. We are looking for a Data and Analytics leader to oversee our Healthcare benefits Data Engineering team to drive innovation and end-to-end value proposition.

The Executive Director role will serve as an executive member of the CVS Health Enterprise Data strategy team, reporting to the Chief Data Officer, and will help drive an industry leading set of data products and capabilities that is a critical enabler of CVS Health overall strategy. This high growth, high impact role will have extensive visibility within the HCB busines unit and across enterprise functions and will also help support CVS internal and external profile in best in class data engineering capabilities.

The Executive Director of HCB Data Engineering will be responsible for strategy and delivery of HCB data strategy in support of key HCB and Enterprise priorities. This individual will lead a multi-level team of engineering professionals in identifying business needs and opportunities and designing, developing, and delivering complex data and descriptive analytics/reporting solutions for the CVS Health Healthcare benefits segment. The successful candidate will be a thought partner for the business leaders across the Healthcare business and data/analytic strategy organization and will develop data solutions across a range of data, BI, Analytics, and AI use cases that support key healthcare business analytical initiatives across Analytics & Behavior Change (A&BC), Finance, Plan Sponsor, Network, Medicare, Medicaid, Digitization, and IT.

The responsibilities of the role include
- Work with business, data, and analytic leaders including A&BC, Finance, Medical Economics, Networks, Operations, Medicare, Medicaid, Digitalization, and IT to understand the business capability needs and use cases and come up with the short-term and long-term engineering roadmap for core HCB data assets across HCB domains
- Lead the execution of the the integrated delivery team model in close partnership with IT to plan and oversee development, implementation and deployment of the overall data engineering solutions ensuring that deliverables align with current and future business strategies and are successfully integrated into existing business processes.
- Develop the overall data architecture, onboarding source data into the data platform, and develop conformed data assets and semantic layer build leveraging the integrated delivery operating model in support of business use cases.
- Lead the strategy and execution to migrate/ transform HCB data pipelines to cloud based environment such as GCP
- Develop, manage, and execute the engineering roadmap for implementing daily membership, daily claims data, revenue data across medical, vision, dental across Commercial, Medicare and Medicaid segments.
- Develop and maintain integrated daily claims data view that can support the business insights across business units including Finance, Medical economics, Provider, Networks, and Analytics, ins support of key use cases like financial reporting, payment integrity, Fraud and other use cases.
- Develop and maintain datamarts, metric layer, data extracts and reports in support of HCB financial processes and provide consistent set of data assets and single source of truth for finance that aligns with other business processes.
- Develop, manage, and execute the engineering roadmap for implementing non-clinical clinical data assets in support of managing UM optimization, Medical Director quality monitoring, and other care management programs by bringing in data from UM platforms including Medcompass, ATV, and others.
- Manage, and execute the engineering roadmap for implementing provider data needs, including attribution/assignment data needs based on the value based contractual arrangement with providers.
- Support data engineering efforts the application of AI in data/ data automation projects across HCB
- Develop, manage, and execute the engineering roadmap for implementing and maintaining member level data assets like Health Profile Data and curated data sets to accelerate insights and data efficiency across business teams.
- Establishing single source of truth and ensuring adequate level of data quality for key HCB data assets focused a across HCB data ecosystem in support of critical business initiatives.
- Develop and grow a team of 30 + colleagues with advanced training, comprised of Data Engineers.
- Develop and manage the resource forecast for the Healthcare benefits business data engineering and appropriately deploy resources against the top initiatives including leveraging flex capacity model.

Required Qualifications
* 10+ years of progressive data and analytic experience in envisioning, developing, delivering, and integrating complex data management solutions including experience with big data and cloud environments and cloud migration.
* Executive level consulting experience in translating business problems across disciplines into data and analytic projects with measurable business value combined with ability and experience to work closely with the individual contributors to efficiently translate plans into reality.
* Demonstrated experience leading internal or external funding efforts for projects based on business value and ROI.
* Data Management experience within the healthcare business/insurance industry, with experience deploying capabilities across a wide range of business disciplines and creating data solutions to a variety of problems.
* Proven experience working across multiple business areas such as Analytics, operations, finance, sales, product, and IT.
* Solid understanding and hands on experience with a variety of Data management and data engineering processes, including data pipeline development, aggregate/semantic data layer development, methodology development, and KPI and metrics layer development.
* Solid understanding and hands on experience working with large data sources, particularly administrative claims, provider, and clinical program/lab data, focusing on efficient data extraction from large databases, data manipulation, and setting up optimized summary data layers.
* Strong background in big data and open source technology (Hadoop, Python, Spark, R)
* Strong background in developing cloud-based data engineering solutions leveraging cloud native tools and optimizing it for cloud.
* Proven team leadership and management experience, with ability to recruit, engage and develop staff with advanced degrees and diverse backgrounds and in different geographic locations, ability to allocate resources based on priority and skill level, strengths, and area of expertise; ability to train and mentor junior colleagues and identify and guide team leaders.
* Proven ability to establish and maintain collaborative relationships with business partners, including executive leadership, in order to elicit business needs and formulate, propose and refine data and reporting solutions in order to meet the business needs and to drive efficiency and effectiveness improvements and business value.
* Excellent written and oral communication and data presentation skills, with ability to tailor the communication style to the right audience, from the data/analytic professional to the senior business leaders.
* Excellent project management skills with ability to lead and engage in multiple projects and initiatives and appropriately prioritize her/his own time as well as that of the direct reports.

Preferred Qualifications
1. Management consulting experience a plus
2. Deep understanding of the healthcare business/Insurance landscape and CVS Health/Aetna business model.

Education
Masters degree required with 10+ years of relevant experience or Bachelors degree with the equivalent experience.

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.