Data Management Strategy and Governance Advisor - HIH - Evernorth
Role Summary Core Responsibilities:
Reference Data Management & Stewardship
- Monitor industry-standard and external reference data source releases to ensure timely assessment and implementation of updates.
- Maintain healthcare industry standard and enterprise proprietary reference data within ERDM platforms.
- Ensure reference data repositories remain accurate, complete, current, and aligned with source system releases and business requirements.
- Support the onboarding, maintenance, validation, certification, and retirement of reference data assets throughout their lifecycle.
- Manage the distribution and availability of trusted reference data to downstream consumers and applications.
- Data Quality & Resolution
- Triage, investigate, and resolve reference data incidents, service requests, and production issues in accordance with established SLAs and operational procedures.
- Conduct root cause analysis of data quality issues and implement corrective and preventive actions in collaboration with upstream and downstream partners.
- Identify data discrepancies, assess business impact, and coordinate remediation activities across business and technology teams.
- Monitor data quality trends and recommend process improvements to reduce recurring issues and operational risk.
- Healthcare Reference Data Expertise
- Apply deep knowledge of healthcare industry-standard code sets, classifications, and reference data assets to support business operations.
- Develop and maintain mappings, crosswalks, and reference data relationships that support claims processing, reimbursement, analytics, regulatory reporting, and other enterprise functions.
- Evaluate the impact of healthcare industry changes, regulatory updates, and external data releases on business processes and systems.
- Provide consultation on reference data usage, governance, and integration across enterprise platforms and applications.
- Business Partnership & Stakeholder Support
- Serve as a subject matter expert for healthcare industry-standard and proprietary reference data.
- Collaborate with business partners to provide guidance, consultation, and expertise regarding the use, interpretation, and application of reference data.
- Partner with business, project, and technology teams to support enterprise initiatives requiring reference data changes, enhancements, or implementations.
- Facilitate stakeholder discussions to gather requirements, assess impacts, and align reference data solutions with business objectives.
- Build and maintain strong relationships with stakeholders to ensure effective communication and service delivery
- Operational Excellence
- Prioritize and manage multiple initiatives, support requests, and operational responsibilities effectively to meet deadlines and business expectations.
- Maintain a high level of accuracy, attention to detail, and accountability in all reference data management activities.
- Adhere to established governance standards, operational procedures, controls, and documentation requirements.
- Continuously identify opportunities to automate, streamline, and improve reference data management processes.
- Communication & Collaboration
- Communicate reference data changes, production issues, risks, and business impacts to stakeholders in a clear and timely manner.
- Provide regular status updates and follow-up communications regarding issue resolution, enhancements, and operational activities.
- Develop and deliver presentations, documentation, and training materials to support stakeholder understanding and adoption of reference data solutions.
- Collaborate effectively within matrixed teams and across business, operational, and technology organizations.
- Strategic Thinking & Problem Solving.
- Apply creative and analytical problem-solving techniques to identify, assess, and resolve complex reference data issues, including those with non-obvious root causes.
- Translate business data challenges into scalable reference data solutions that meet the needs of multiple stakeholders and business functions.
- Anticipate future business and data needs by recommending improvements to reference data processes, controls, and governance practices.
- Influence business partners and stakeholders to adopt reference data standards, governance principles, and enterprise data management best practices
Required Qualifications:
- Bachelor’s degree in business, Healthcare Administration, Information Management, Computer Science, or a related field; master’s degree preferred.
- 5+ years of experience in Enterprise Reference Data Management, Data Governance, Data Management, or Data Operations.
- 5+ years of experience working with healthcare industry-standard code sets, including CPT, HCPCS, ICD, DRG, NDC, and related healthcare reference data assets.
- Demonstrated knowledge of healthcare reference data usage across claims processing, reimbursement, provider management, regulatory reporting, analytics, and operational systems.
- Proven ability to translate business requirements into data management solutions, operational processes, and actionable deliverables.
- Experience conducting data analysis, root cause analysis, and issue remediation within a complex business environment.
Preferred Qualifications:
- Strong organizational, planning, and prioritization skills with exceptional attention to detail.
- Familiarity with AI-enabled, automation, and data management technologies to improve operational efficiency and data quality.
- Experience working with data management and governance platforms such as Collibra, Alation, Databricks, Informatica, or similar technologies.
- CPC, RHIA, RHIT, or other relevant healthcare industry certifications.
- Experience working in Agile, Scrum, or other iterative delivery environments.
- Experience supporting regulatory, compliance, and healthcare data modernization initiatives.
Key Competencies:
- Executive-level communication and stakeholder engagement
- Cross-functional collaboration (Business, Engineering, Governance)
- Operational leadership and process optimization
- Data-driven decision-making
- Strategic thinking with hands-on execution capability.
Equal Opportunity Statement:
Evernorth is an Equal Opportunity Employer actively encouraging and supporting organization-wide involvement of staff in diversity, equity, and inclusion efforts to educate, inform and advance both internal practices and external work with diverse client populations
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
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