Lead Director- Informatics Reporting

CVS Health•Work At Home-Connecticut, CT

3d•$100,000 - $231,540

About The Position

The Lead Director – Informatics is responsible for defining and executing the data and reporting strategy for the Grievances & Appeals (G&A) organization, enabling timely, accurate, and actionable insights to improve operational efficiency, compliance, and decision-making. This role builds internal analytics capabilities, strengthens reporting processes, and develops a high-performing team.

Requirements

10+ years of experience in informatics, analytics, or business intelligence
Strong healthcare domain experience, preferably in: Claims, grievances, authorization and appeals
Demonstrated leadership in data strategy, reporting, and team development

Nice To Haves

Experience in Aetna EDP platform.
Experience in GCP (Big Query, Looker, Cloud)
Experience in implementing AI technologies into existing reporting processes.
Experience Coginiti, Dataiku, Tableau, PBI, SAP reporting tools, Quick Base.
Familiarity with Agile SDLC.
Proficient in Office tools (Power point/Excel/word) and Share point.
Experience engaging with executive leadership.
Experience in identifying and implementing process improvements.
Experience leading analytics team and translating their requirements into clear, actionable solutions.

Responsibilities

Manages and optimizes Informatics reporting processes, systems, and strategies to provide accurate and timely information to key stakeholders.
Provides strategic leadership in the development and execution of reporting strategies aligned with the organization's goals.
Oversees the selection, implementation, and maintenance of reporting systems, schedules, and infrastructure.
Evaluates and recommends appropriate reporting tools, databases, and platforms to support efficient and accurate reporting processes.
Collaborates with stakeholders to identify reporting needs and requirements, design and create meaningful visualizations, and ensure data accuracy and consistency.
Establishes and enforces reporting governance frameworks, policies, and procedures by ensuring compliance with relevant regulations, such as data privacy, security, and industry standards.
Identifies opportunities to enhance reporting efficiency, accuracy, and usability through automation, data visualization, and self-service reporting capabilities.
Establishes performance metrics and reporting mechanisms to assess the effectiveness of reporting initiatives.
Act as a bridge between IT delivery, enterprise analytics, and clinical/Operational leadership to ensure risk management and regulatory compliance needs.
Leads teams of data analysts and specialists to analyze core G&A data and generate actionable insights.
Enables visibility into: Appeals turnaround time, Overturn reduction drivers, Grievance trends, Root cause analysis, Regulatory performance metrics, Productivity Metrics.
Drives proactive insights for operational improvement and compliance readiness.
Ensures adherence to healthcare regulations and audit requirements specific to grievances and appeals.
Maintains high standards of data integrity, traceability, and auditability.
Aligns reporting practices with enterprise data governance standards.
Builds in-house informatics and analytics capabilities to reduce reliance on external teams.
Establishes scalable operating models, reusable data assets, and self-service solutions.
Drives continuous improvement through automation and standardization.
Creates robust job functions and role clarity within the informatics team.
Leads, mentors, and develops talent across analytics, reporting, and domain expertise.
Promotes a growth mindset, agility, and continuous learning culture.
Applies deep expertise in: Healthcare claims, grievances, authorization and appeals processes, Appeals lifecycle management and compliance tracking.
Ensures data and reporting enable regulatory compliance, audit readiness, and operational excellence.