We are seeking a Director, Business Analytics & Intelligence to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role
The Director, Business Analytics & Intelligence is responsible for leading the California market's business data strategy, business intelligence, reporting, and performance analytics functions. This role serves as a strategic partner to operational, clinical, quality, compliance, and provider network leaders by transforming complex data into actionable insights that support organizational goals, regulatory requirements, provider performance improvement, and member outcomes. The Director, Business Analytics &Intelligence is accountable for developing and maintaining provider-facing and executive reporting, monitoring provider network performance, identifying operational trends and opportunities, ensuring data integrity, and supporting data-driven decision-making across the California market. The Director, Business Analytics & Intelligence leads the development of dashboards, scorecards, predictive analytics, and business intelligence solutions that enable leadership to effectively manage provider relationships, delegated entities, network adequacy, quality performance, utilization trends, and contractual obligations. This role requires a combination of healthcare operations expertise, analytical leadership, business acumen, and strong stakeholder management skills to drive operational excellence and continuous improvement throughout the California provider network.
Minimum Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Data Analytics, Public Health, Information Systems, Statistics, Finance, or a related field.
- Seven (7) years of progressive experience in healthcare analytics, business intelligence, managed care operations, provider network management, population health, healthcare finance, or related healthcare environments.
- Minimum of three (3) years of leadership experience overseeing analytics, reporting, business intelligence, or operational performance initiatives.
- Advanced proficiency in data analysis, dashboard development, and reporting tools such as Power BI, Tableau, SQL, Excel, and other business intelligence platforms.
- Experience analyzing provider performance, healthcare utilization, quality measures, operational metrics, and financial performance indicators.
- Strong understanding of managed care operations, care delivery, provider networks, Medicare, Medicaid, CMS requirements, and healthcare regulatory environments.
- Demonstrated ability to translate complex data into actionable business recommendations for executive leadership.
- Strong project management, communication, and stakeholder engagement skills.
- Relevant experience may substitute for educational requirement on a year-for-year basis.
Preferred Qualifications
- Master's degree in Healthcare Administration, Business Administration, Public Health, Data Science, Analytics, Finance, or a related discipline.
- Experience working within California managed care organizations, health plans, IPA/MSO environments, or delegated provider networks.
- Knowledge of CMS, DHCS, NCQA, HEDIS, delegated oversight, network adequacy, and healthcare quality reporting requirements.
- Experience developing performance scorecards, executive dashboards, predictive modeling, and performance improvement initiatives.
- Certification in business intelligence, data analytics, project management, healthcare quality, or related disciplines.
- Experience leading reporting and data governance initiatives.
Responsibilities
- Demonstrates commitment to Our Mission and models ILS Experience Standards of Excellence.
- Serve as the California Market's lead for provider analytics, business intelligence, reporting, and performance measurement activities.
- Develop and maintain executive dashboards, provider scorecards, operational reports, and performance metrics that support strategic and operational decision-making.
- Analyze provider performance, network adequacy, utilization trends, quality outcomes, member experience data, and operational performance indicators.
- Partner with Provider Network, Operations, Quality/Performance Improvement, Compliance, Care Management, Finance, and Executive Leadership teams to identify opportunities for improvement and operational efficiencies.
- Lead the development and implementation of business intelligence strategies, reporting frameworks, and analytics solutions that support organizational goals.
- Monitor key business performance indicators er network performance and identify emerging trends, risks, and opportunities requiring leadership attention.
- Ensure the accuracy, integrity, and consistency of provider-related data across reporting platforms and operational systems.
- Develop predictive and trend analyses to support strategic planning, provider engagement, network expansion, and performance improvement initiatives.
- Support delegated oversight activities, regulatory reporting requirements, provider audits, corrective action plans, and operational reviews through data analysis and reporting.
- Present findings, recommendations, and performance updates to executive leadership, provider partners, committees, and other stakeholders.
- Collaborate with Information Technology, the innovation Team and data management teams to improve reporting capabilities, automation, and data governance processes.
- Establish and monitor key performance indicators (KPIs) for provider operations, network performance, quality outcomes, utilization management, and member satisfaction in partnership with operational leaders
- Lead special projects, market analyses, and strategic initiatives as assigned by the Senior Vice President, California Market.
- Perform other duties as assigned.
Skills Required
- Bachelor's degree in Healthcare Administration, Business Administration, Data Analytics, Public Health, Information Systems, Statistics, Finance, or a related field; relevant experience may substitute year-for-year.
- Seven years of progressive experience in healthcare analytics, business intelligence, managed care operations, provider network management, population health, healthcare finance, or related healthcare environments.
- At least three years of leadership experience overseeing analytics, reporting, business intelligence, or operational performance initiatives.
- Advanced proficiency in data analysis, dashboard development, and reporting tools including Power BI, Tableau, SQL, Excel, and other business intelligence platforms.
- Experience analyzing provider performance, healthcare utilization, quality measures, operational metrics, and financial performance indicators.
- Strong understanding of managed care operations, care delivery, provider networks, Medicare, Medicaid, CMS requirements, and healthcare regulatory environments.
- Ability to translate complex data into actionable business recommendations for executive leadership.
- Strong project management, communication, and stakeholder engagement skills.
- Master's degree in Healthcare Administration, Business Administration, Public Health, Data Science, Analytics, Finance, or a related discipline.
- Experience working within California managed care organizations, health plans, IPA/MSO environments, or delegated provider networks.
- Knowledge of CMS, DHCS, NCQA, HEDIS, delegated oversight, network adequacy, and healthcare quality reporting requirements.
- Experience developing performance scorecards, executive dashboards, predictive modeling, and performance improvement initiatives.
- Certification in business intelligence, data analytics, project management, healthcare quality, or related disciplines.
- Experience leading reporting and data governance initiatives.
What We Do
Independent Living Systems, LLC, offers a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid and Dual-Eligible Market. Independent Living Systems has been an industry leader in managing home and community-based programs for over 16 years. Leveraging ILS’ award winning technology platform, ILS provides assistance beyond the clinical realm at every stage of care from hospitalization to the treatment of chronic illnesses to personalized care management including nutritional support. As one of the country’s leading providers of Nutritional Support Services and medically tailored meals, ILS provides nutrition counseling and home delivered meals for individuals transitioning from acute settings to the home as well as for those combatting the effects of one or more chronic diseases. In partnership with health plans, providers, hospitals, and pharmaceutical and medical device companies, ILS provides solutions aimed at improving health outcomes while rebalancing costs. ILS’ suite of products and services include: MLTSS - Managed Long-Term Services Supports Suite of solutions including assessments, care management, and coordination of home and community-based services, care planning, and back-office support CCM - Comprehensive Care Management A streamlined solution for ongoing care management and care optimization targeted towards special needs populations and special needs plans Meals and Nutrition One of the nation’s largest nutritional providers delivering consistent, high-quality therapeutic meals to elderly and at-risk populations TPA – Third Party Administration A fully integrated business and technology offering to support all administrative and financial reporting requirements of health plans and risk bearing entities MSO – Management Services Organization Population and provider-based interventions to address utilization and monitor unit costs of services For more information please contact us via email at [email protected].
