Director, Contract Insights Solutions

Job Summary:

The Director, Contract Insights Solutions is responsible for leading the strategy, design, and oversight of the technical infrastructure, analytics platforms, and data products that support the Provider Contract Analytics function. This role directs a team responsible for building and maintaining scalable pricing engines, claims modeling frameworks, data tables, and business intelligence tools used for provider contracting, reimbursement analytics, and performance monitoring. The Director partners closely with Reimbursement Analytics, Configuration, IT, and Actuarial teams to ensure the organization has accurate, reliable, and timely analytic tools and data assets that enable data-driven decision making, support network optimization, and ensure alignment with regulatory and contractual requirements.

Essential Functions:

• Own data architecture and governance strategy for PCA tables, SQL pipelines, and pricing engines
• Lead design and implementation of large-scale claims pricing models
• Oversee validation frameworks to ensure accuracy and alignment with reimbursement policy
• Design and manage Power BI dashboards, data marts, and analytic tools to support market contracting
• Establish and enforce standards for reports, tables, KPIs, and reusable code logic
• Maintain centralized, version-controlled code repositories for pricing models and analytics
• Collaborate with Reimbursement Analytics and Configuration teams to align contract language, configuration, and pricing tools
• Develop and monitor data quality controls to ensure the integrity of claims and provider data
• Automate recurring reports and analytic workflows to increase efficiency
• Act as technical subject matter expert to market analytics teams
• Manage vendor relationships for pricing and analytics platforms
• Hire, train, mentor, develop and evaluate a team of technical analysts, data engineers, and BI developers
• Track department-level SLAs and performance metrics for pricing turnaround, data refresh, and tool availability
• Perform any other duties as requested

Education and Experience:

• Bachelor’s degree in computer science, data science, engineering, analytics, or related field or equivalent years of relevant work experience is required
• Master’s degree in business analytics, data engineering, or healthcare informatics preferred
• Minimum of eight (8) years of experience in data analytics, engineering, or healthcare financial modeling is required, managed care preferred
• Minimum of five (5) years of leadership experience to include managing technical teams and cross-functional data/platform initiatives required
• Experience designing enterprise data solutions, pricing engines, or large-scale healthcare analytics systems required
• Experience with Medicaid, Marketplace, and Medicare reimbursement structures strongly preferred

Competencies, Knowledge and Skills:

• Advanced proficiency in SQL, Databricks, and data pipeline development
• Proficiency in Power BI or similar BI tools for enterprise reporting
• Strong understanding of healthcare data structures (claims, provider, reimbursement)
• Experience building and maintaining analytic architectures and code repositories
• Strong leadership and team development skills
• Excellent communication and stakeholder engagement abilities
• Strong problem-solving and critical thinking in complex data environments
• Ability to manage multiple priorities, drive standardization, and lead change

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time.
• Occasional travel may be required for meetings with key providers or stakeholders

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business