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