Manager, Business Intelligence - RCMS (EHR platform, RCM/billing related BI)

Job Description:

Qualifacts is the leading behavioral health technology partner, specializing in AI-powered electronic health record (EHR) software and data solutions. Putting the health of individuals first, our award-winning solutions enable behavioral health providers to spend more time on what matters most: delivering superior care that drives better outcomes. Qualifacts is more than a provider of innovative technology—we’re partners in care, working alongside organizations of all sizes nationwide to simplify the lives of behavioral health providers. We simplify clinical workflows and ensure compliance, while strengthening client-provider relationships. Today, we serve more than 2,700 organizations across all 50 states, including 33% of the nation’s Certified Community Behavioral Health Centers (CCBHCs), supporting both non-profit and for-profit organizations in delivering superior behavioral healthcare.

If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today!

This is an onsite position, 5 days/week, in the Vadodara office working the NIGHT SHIFT. Hours are 6:30pm-3:30am IST. Remote applicants will not be considered.

Summary of the Manager, Business Intelligence - RCMS
The Manager, Business Intelligence – RCMS will partner with RCMS leadership, Revenue Optimization, Finance, Product, Technology, Customer Success, Quality, Compliance, and client-facing teams. They will be responsible for building trusted and scalable analytics that convert claims, remittance, payment, denial, A/R, productivity, customer, and financial data into operational intelligence and action. They will own the RCMS reporting and analytics framework, governed BI solutions, KPI standards, delivery roadmap, data-quality controls, and analytics lifecycle; escalates material data, security, delivery, or control risks.

Responsibilities for the Manager, Business Intelligence – RCMS

- Develop and manage the RCMS business intelligence roadmap, demand portfolio, priorities, capacity, and stakeholder communication, converting recurring requests into reusable data products aligned to performance, customer value, growth, automation, and scalability

- Lead BI analysts and developers and establish standards for requirements, design, development, documentation, testing, release, support, and continuous improvement

- Design analytics for claims, clean claims, rejections, denials, payments, underpayments, A/R, DRO, collections, productivity, quality, backlog, retention, and cost-to-serve

- Lead root-cause, cohort, trend, variance, funnel, segmentation, exception, and predictive analyses across payer, client, platform, workflow, staffing, training, and quality drivers, translating findings into prioritized interventions and measurable operational or financial impact

- Own governed Snowflake data products, including dimensional and semantic models, reusable views, data marts, metric layers, and curated datasets; use advanced SQL to control grain, duplication, lineage, reconciliation, transformation, performance, and consumption risk

- Partner with data engineering and platform teams on ingestion, orchestration, transformation, and monitoring using dbt, Airflow, APIs, and approved integration technologies

- Lead Power BI dashboards, semantic models, DAX measures, reports, security, performance, deployment, and support using common design standards for executive, operational, client, and analyst audiences

- Enable governed self-service through certified datasets, role-based access, documentation, training, usage monitoring, and lifecycle management that moves users from visibility to diagnosis, prioritization, and action

- Own RCMS KPI definitions, formulas, sources, dimensions, exclusions, refresh expectations, targets, ownership, and transparent communication of assumptions or limitations

- Establish automated quality controls, reconciliation, anomaly detection, release validation, monitoring, and remediation while protecting data through least-privilege access, masking, secure development, source control, testing, and compliance with HIPAA, privacy, security, and company requirements

- Prioritize AI, machine learning, RPA, intelligent automation, and workflow orchestration opportunities with defined business cases, acceptance criteria, controls, adoption plans, and benefit tracking

- Lead discovery, process mapping, prototypes, user acceptance testing, deployment, executive narratives, client-ready analytics, and data-literacy enablement across clients, platforms, service lines, and geographies

Qualifications of the Manager, Business Intelligence – RCMS

- Bachelor's degree in Computer Science, Information Systems, Data Analytics, Healthcare Analytics, Finance, Engineering, or a related field; experience in lieu of degree acceptable

- 6+ years of progressive BI, analytics engineering, reporting, or data analytics experience, including leadership of projects, analysts, or developers

- Healthcare RCM analytics expertise across claims, 837/835 transactions, remittances, denials, payments, A/R, payer behavior, reimbursement, and productivity

- Advanced SQL and hands-on Snowflake experience in modeling, transformation, query optimization, quality validation, and reusable analytical datasets

- Strong Power BI experience with semantic modeling, DAX, Power Query, dashboard design, optimization, security, deployment, and support

- Experience with KPI governance, lineage, access controls, testing, source control, release management, and production monitoring

- Experience with Airflow, APIs, Python, R, Sigma, Tableau, Looker, or comparable approved technologies

- Experience enabling AI, machine learning, RPA, intelligent automation, or workflow analytics in a controlled business environment

- Healthcare technology, RCM services, BPO, shared services, or multi-client environment experience

Knowledge, Skills, and Abilities of the Manager, Business Intelligence – RCMS

- Connect billing, payer, claims, denials, remittance, payments, A/R, collections, leakage, productivity, and customer performance

- Design trusted products from ingestion through Snowflake modeling, semantic layers, BI delivery, governance, and adoption

- Apply Power BI and modern BI practices to create accurate, maintainable, performant, accessible, reusable analytics

- Use root-cause analysis, statistics, segmentation, trends, and hypothesis testing to translate findings into action

- Build durable definitions, lineage, reconciliation, access, testing, monitoring, and change controls

- Apply appropriate use cases, limitations, controls, and value measures for AI, ML, RPA, and assisted development

- Connect analytics to cash, revenue, margin, cost-to-serve, capacity, client value, and scalable growth

- Set standards, coach technical talent, manage analytics as products, and explain complex concepts clearly

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.