Clinical Data Governance Lead - Enterprise Quality & Accreditation - Hybrid

Role Summary:

Effective execution of good data governance principles and practices minimizes risk and ensures the data is available and fit for purpose.

As part of The Cigna Group's Enterprise Clinical & Health Organization (ECHO), the Clinical Data Governance Lead is responsible for overseeing the integrity, quality, and governance of data critical to ECHO operations, programs, and strategies.

Ideal candidates should have strong background on health care payer Clinical operations / programs and related clinical data standards with drive towards business enablement and quality improvement.

Responsibilities:


* Implements data ownership / data stewardship practices and serves as the primary business contact for data-related decisions and accountability to ensure appropriate data use, access, standards, quality, controls, and metadata / knowledge management for Clinical data and data assets.


* Leads Data Governance initiatives and collaborations with Clinical business and IT operational stakeholders to:
+ Set data governance priorities based on business operational needs and regulatory / market demands
+ Work closely with business and technology partners to implement data governance priorities / requirements
+ Continuously improves and enhances data governance best practices for the organization


* Implements Operational Data Governance, controls, and risk management as 1st Line of Defense


* Partners closely with Enterprise Data Governance and Data Stewards to align / implement enterprise data standards and data governance best practices and support 2nd Line of Defense data governance oversight, standards, and monitoring at the enterprise level as well as 3rd Line of Defense activities with Internal and External Audit parties as required.

Qualifications:


* Bachelor's degree or higher


* 7+ years professional work experience in:
+ Data Governance, Data Management, Data Quality, or Process Improvement practices
+ Healthcare payer data products and processes
+ Clinical data standards and operations, including:
o Clinical terminology, concepts, business processes and data management lifecycle related to Health Services, Care Management, and Health / Wellness programs (e.g., utilization management, case management, demand management, medical review, care plans, health care coaching, incentives, etc.)
o Health Profiles / History (e.g., health assessments, electronic medical records, etc.)
o Health Measurement (population health, evidence-based medicine, episodes of care, gaps in care, health risk scores, next best actions, HEDIS, NCQA, performance guarantees, etc.)
o Clinical operational source systems (e.g., TruCare, Evicore, MDLive, etc.) and related operational / analytic reporting systems
o Healthcare Interoperability, HIE / EDI data exchange, and EMR standards and solutions (e.g., HL7...