The posting
Job Description:
Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.
As one of the largest EHR companies in the country, Qualifacts offers revolutionary support for behavioral health, human services, and rehabilitative services. The technology and solutions that we provide enhance how our customers deliver quality care, make it possible for them to achieve exceptional outcomes, and improve the lives of the individuals they serve. We draw upon 20 years of experience to inform our products and services, and the result is solutions that empower our customers to achieve interoperability goals, optimize efficiency, improve productivity, and maximize reimbursement.
Qualifacts supports three platforms: CareLogic, Credible, and InSync. The EHR platforms, each uniquely positioned, allow us to serve all segment sizes within the market.
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.
RCM Business Intelligence Strategy and Leadership
• Own the RCMS BI roadmap and demand portfolio, aligning priorities with service performance, customer value, growth, automation, and scalability; manage intake, capacity, delivery, and stakeholder communication.
• Serve as the RCM BI subject-matter expert and trusted advisor, translating business questions into measures, insights, and actionable recommendations.
• Lead and develop BI analysts and developers; establish standards across the analytics lifecycle and replace recurring ad hoc reporting with reusable data products.
RCM Analytics and Performance Intelligence
• Deliver analytics across charge capture, claim submission, clean claims, rejections, denials, payments, remittances, underpayments, A/R aging, days revenue outstanding, collections, first-pass resolution, productivity, quality, backlog, turnaround time, customer retention, and cost-to-serve.
• Use root-cause, cohort, trend, variance, funnel, segmentation, and predictive analyses to identify payer, client, platform, workflow, staffing, training, quality, and upstream drivers; quantify financial and operational impact.
• Develop work-prioritization and exception-management insights; partner with Revenue Optimization and operations leaders to validate findings, target high-value opportunities, and measure sustained improvement.
Snowflake, Data Modeling, and Analytics Engineering
• Own governed Snowflake data products, including dimensional and semantic models, reusable views, data marts, metric layers, and curated datasets.
• Write and review advanced SQL and transformations; optimize query performance, workloads, and consumption while controlling data grain, duplication, lineage, and reconciliation risks.
• Partner with data engineering and platform teams on ingestion, orchestration, transformation, and monitoring using dbt, Airflow, APIs, and approved technologies; maintain definitions, dictionaries, source-to-target logic, ownership, refresh expectations, and support documentation.
BI Tools, Visualization, and Self-Service Analytics
• Lead Power BI dashboard, semantic model, measure, and report development using strong modeling, DAX, visualization, accessibility, performance, security, and deployment practices.
• Apply common design standards across Power BI, Sigma, Tableau, Looker, and other approved tools; deliver intuitive executive, operational, client, and analyst experiences without duplicative reporting.
• Enable self-service analytics through certified datasets, governed models, role-based access, documentation, and training; manage dashboard ownership, usage, enhancement, retirement, and support.
Data Governance, Quality, and Controls
• Own RCMS KPI and reporting governance, including approved formulas, sources, dimensions, exclusions, refresh schedules, targets, and accountable owners; communicate assumptions, limitations, and quality issues.
• Establish automated quality checks, reconciliations, anomaly detection, release validation, and production monitoring with documented thresholds and remediation; enforce source control, peer review, testing, environment separation, and change documentation.
• Protect patient, customer, employee, and financial data through role-based access, least privilege, masking, secure development, and compliance with HIPAA, privacy, security, and company requirements.
AI, Automation, and Scalable Growth
• Prioritize AI, machine learning, RPA, intelligent automation, and workflow orchestration opportunities that reduce manual effort, detect revenue leakage, improve work prioritization, and increase capacity.
• Enable analytics for approved RCMS platforms and develop reusable, configurable data products that scale across clients, platforms, service lines, and geographies.
• Use approved AI-assisted tools with human review, data protection, accuracy, and auditability; define investment business cases, acceptance criteria, baselines, adoption plans, and benefit tracking.
Stakeholder and Customer Enablement
• Partner with RCMS Operations, Revenue Optimization, Finance, Product, Technology, Customer Success, IQuality, Compliance, and client-facing teams on requirements, process mapping, metric definitions, prototypes, user acceptance testing, adoption, and outcome measurement.
• Deliver concise executive and client-ready narratives explaining performance, causes, impact, and recommended actions; provide training, office hours, documentation, and data literacy support.
Qualifications of the Manager, Business Intelligence - RCM
• Bachelor’s degree in computer science, Information Systems, Data Analytics, Healthcare Analytics, Finance, Engineering, or a related field; advanced degree preferred.
• 6+ years in BI, analytics engineering, reporting, or data analytics, including leadership of projects, analysts, or developers.
• Healthcare revenue cycle analytics experience covering claims, 837/835 transactions, remittances, denials, payments, A/R, payer behavior, reimbursement, and productivity.
• Advanced SQL and direct Snowflake experience, including modeling, transformation, optimization, data-quality validation, and reusable datasets.
• Strong direct Power BI skills in semantic modeling, DAX, Power Query, dashboard design, performance, security, deployment, and support; other BI tools beneficial.
• Experience with transformation, integration, and orchestration tools such as dbt, Airflow, APIs, Python, R, or comparable approved technologies.
• Experience with data governance, KPI standards, lineage, access controls, testing, source control, releases, and production monitoring.
• Preferred: AI, machine learning, RPA, intelligent automation, or workflow analytics experience in a controlled business environment; experience in healthcare technology, RCM services, BPO, shared services, or multi-client environments.
Knowledge, Skills, and Abilities
• RCM domain expertise: Connects healthcare billing, payer, claims, denial, remittance, payment, A/R, collection, revenue leakage, productivity, and customer-performance concepts to useful analytics.
• Analytics architecture: Designs trusted data products from source ingestion through Snowflake modeling, semantic layers, BI delivery, governance, and user adoption.
• Business intelligence development: Applies Power BI and modern BI best practices to create accurate, maintainable, performant, accessible, and reusable analytics.
• Analytical problem solving: Uses structured root-cause analysis, statistics, segmentation, trend analysis, and hypothesis testing to distinguish signal from noise and translate findings into action.
• Data governance and quality: Builds durable metric definitions, lineage, reconciliation, access, testing, monitoring, and change-control practices.
• AI and automation fluency: Understands appropriate applications, limitations, controls, and value measures for AI, machine learning, RPA, and AI-assisted analytics development.
• Financial and operational acumen: Connects analytics to cash, revenue, margin, cost-to-serve, capacity, client value, contractual performance, and scalable growth.
• Leadership and talent development: Sets standards, coaches technical talent, plans capacity, improves delivery discipline, and creates accountability for quality and outcomes.
• Executive communication: Explains complex data and technical concepts clearly to non-technical leaders, operating teams, and client stakeholders.
• Product and change mindset: Manages analytics as products with defined users, outcomes, roadmaps, adoption measures, lifecycle ownership, and continuous improvement.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
