JOB SUMMARY
The Vice President of Data Management and Analytics will serve as the lead Database Administrator and oversee a team responsible for data analytics and reporting for a Texas-based HMO offering an Individual ACA product and TPA services. This executive will ensure the integrity, security, and accessibility of critical health plan data while optimizing reporting processes across all business functions, including regulatory compliance, financial reporting, medical management, provider network operations, customer service and other needs as identified by leadership. The VP will drive data governance, business intelligence, and reporting automation to support decision-making and operational efficiency. They will also work closely with compliance, finance, medical management, network teams and the Enterprise Tech Team to ensure timely and accurate reporting aligned with regulatory and business needs.

Essential Functions
JOB FUNCTIONS
Essential Functions
• Database Administration & Management
o Lead the design, implementation, and maintenance of databases supporting health plan operations.
o Ensure data integrity, security, and performance optimization across platforms.
o Oversee database architecture, backups, disaster recovery, and system scalability.
• Data Analytics & Reporting Oversight
o Manage a team responsible for developing and maintaining reports for regulatory agencies, financial audits, medical management, provider network performance, and customer service operations and other reporting needs
as identified by senior management.
o Ensure timely and accurate submission of required reports to regulatory bodies e.g., CMS, Texas
Department of Insurance (TDI).
o Drive automation and standardization of reporting processes to improve efficiency.
• Regulatory & Compliance Alignment
o Maintain compliance with ACA, HIPAA, TDI and other state and federal regulations regarding health data management and reporting.
o Collaborate with finance, medical management, network and compliance teams to ensure accurate and timely regulatory filings.
• Cross-Functional Collaboration
o Partner with Finance, Medical Management, Provider Network, Customer Service teams, TPA Clients and other needs as identified to meet reporting and data analysis needs.
o Work with actuarial and financial teams to support risk adjustment, EDGE reporting, claims reconciliation, and premium forecasting.
• Technology & Process Optimization
o Identify opportunities to modernize IT infrastructure and enhance business intelligence capabilities.
o Research, propose and implement (with approval), data warehousing, reporting tools, and analytics solutions to improve data accessibility.
o Evaluate and manage vendor relationships related to data analytics and IT services.

Required: Bachelor's Degree (higher degree accepted) in Computer Science, Information Systems,
Health Informatics, or a related field.

Minimum of 10+ years of experience in database administration, data analytics, and reporting in a healthcare or insurance setting.