Vālenz® Health

Compliance

• Lead internal audits, operational reviews, and risk assessments, including pre- and post-implementation evaluations.
• Manage the development, revision, and documentation of compliance policies, procedures, and training materials.
• Serve as the primary intake for compliance-related questions, Hotline submissions, and incident reports; provide timely, well-reasoned recommendations.
• Collaborate with leadership on mitigation plans and root cause analysis tied to regulatory or contractual noncompliance.
• Represent Compliance in client-facing meetings, audits, and business reviews.
• Monitor and interpret applicable laws, regulations, and delegation requirements (ERISA, HIPAA, CMS, HHS-OCR, DOL, URAC, NCQA), translating them into practical guidance.
• Review healthcare claims, coding structures (ICD-10, DRG, CPT), and workflows to identify risks and ensure compliance.
• Support vendor and third-party compliance documentation, including audit coordination and follow-up.
• Maintain compliance logs, records, and investigation documentation.
• Assist with board-level reporting, internal committee materials, and responses to payer/client audits of delegated functions.
• Serve as a trusted compliance partner to operational, legal, and product teams.

Senior Healthcare Compliance Analyst

Product Manager

• Define and execute the long-term product vision and roadmap for the Valenz Health technology platform.
• Align platform and product strategy with enterprise financial and operational goals.
• Drive adoption of modern integration standards (FHIR, APIs, EDI) to enable efficient interoperability with third-party systems.
• Lead and mentor a team of product directors and managers across data services, APIs, and AI/analytics.
• Oversee prioritization and lifecycle management for platform components, including data ingestion, interoperability, reporting, identity, and security.
• Partner with engineering to ensure timely, high-quality delivery of platform capabilities.
• Work with compliance and regulatory teams to ensure HIPAA, HITRUST, and other standards are met.
• Collaborate with product and engineering leaders to shape, refine, and prioritize the platform roadmap.
• Monitor emerging healthcare technology trends (FHIR, HL7, AI, RCM automation, population health) to inform platform strategy.
• Identify opportunities for data monetization, AI enablement, and interoperability-driven innovation.
• Engage with external partners (EHR vendors, payers, cloud providers) to create strategic alliances.
• Demonstrate deep understanding of healthcare data standards (FHIR, HL7, HIPAA) and API-driven ecosystems.
• Perform other duties as assigned.

VP of Product Management – Platform

• Define and execute the long-term product strategy aligned with company goals and emerging healthcare industry trends.
• Lead, mentor, and develop the product management organization across the Member Experience product family.
• Drive innovation that enhances differentiation, operational efficiency, and member/patient engagement.
• Oversee the full product lifecycle, including market analysis, business case development, roadmap prioritization, launch, and post-market optimization.
• Ensure compliance with healthcare regulations (HIPAA, FDA, CMS, interoperability standards).
• Collaborate with customers and stakeholders to validate product investments, commercial viability, and value.
• Partner with health systems, payers, providers, and patient-facing stakeholders to understand evolving needs and new opportunities.
• Monitor competitive landscape and market dynamics to inform product decisions.
• Partner closely with engineering, UI/UX, and operations to deliver high-quality, scalable solutions.
• Work with marketing, sales, and customer success to ensure strong go-to-market execution and adoption.
• Develop business cases, pricing strategies, and ROI analyses.
• Manage product P&L performance and optimize resource allocation.
• Perform other duties as assigned.

VP of Product – Member Experience

Data Engineer

• Drive continuous improvement initiatives to enhance data processing capabilities across the organization
• Design and implement efficient, high-performance data ingestion pipelines from diverse sources utilizing Databricks on Azure
• Develop and maintain reliable data pipelines, automating manual processes to improve efficiency and scalability
• Collaborate with the Data Engineering team to design and support robust processes for loading data into relational, dimensional, and NoSQL database systems
• Implement best practices in data lake architecture to ensure scalable, standardized, and optimized data storage and processing solutions
• Partner with cross-functional teams to identify, evaluate, and acquire new data sources that align with organizational objectives
• Actively participate in agile development processes, contributing to sprint planning, refinement, and delivery of high-quality solutions

Data Engineer II

Analyst

• As a Senior Analyst, you’ll work with medical and pharmacy claims to build and maintain data products that support member healthcare navigation, employer compliance, and pharmacy savings initiatives. You’ll resolve data issues, respond to client inquiries, and use tools like SQL and Python to enhance analytics workflows and internal reporting. Your work will deliver accurate, actionable insights that improve decision-making, streamline operations, and drive value across the organization in a fast-paced, collaborative environment.

Senior Analyst – Healthcare Insights, Quality

Vice President

• Develop and implement a strategic vision for broker, consultant and employer sales, ensuring alignment with company objectives and market opportunities.
• Train and mentor a high-performing broker sales team, fostering a player-lead culture of accountability, collaboration, and continuous improvement.
• Develop targeted sales strategies and provide timely updates to management.
• Cultivate strong relationships with key stakeholders and broker/consultant offices across the country to establish trust and drive the adoption of our solutions.
• Develop and monitor sales team and individual KPIs, providing data-driven insights and reporting to inform decision-making and improve outcomes driving the sales strategy and plan.
• Partner with teams across the organization to ensure broker sales alignment with broader company objectives, customer needs and marketing initiatives.
• Coordinate efforts to ensure that Valenz services are delivered efficiently and effectively.
• Thoroughly understand all Valenz products and services, including their features, benefits, and competitive differentiators.
• Stay up to date on industry trends and developments.
• Attend industry events and trade shows to network with prospects and generate new business.
• Set up meetings with prospects and use these events as an opportunity to showcase Valenz services.
• Keep accurate and up-to-date records of all prospect interactions in the customer relationship management (CRM) system.

SVP, Broker Solutions

Customer Success Manager

• Lead pre- and post-sale presentations and coordinate regular client meetings to maintain strong relationships and ensure alignment on goals and services.
• Drive revenue growth through upselling, cross-selling, and strategic account planning across assigned clients.
• Manage and track sales opportunities using the CRM system to ensure accurate pipeline visibility and follow-up.
• Oversee client proposals, renewals, and implementations, ensuring timely and effective execution in collaboration with internal teams.
• Develop and maintain Strategic Account Plans that outline client goals, key initiatives, and growth opportunities.
• Serve as the primary client contact, ensuring timely communication, issue resolution, and overall satisfaction.
• Demonstrate strong knowledge of Vālenz products and services, effectively aligning solutions with client needs.
• Collaborate with internal teams to resolve client issues, improve service delivery, and streamline processes.
• Ensure compliance with company policies, procedures, and HIPAA standards in all client interactions.
• Partner with Operations, SMEs, and other departments to meet client requirements and strengthen relationships.

Client Success Executive

Bilingual

• Receive inbound calls, faxes, and web requests from providers and/or clients
• Initiate and facilitate the authorization process in accordance with established health plan policies and procedures
• Document demographic information obtained from telephonic, fax, or emailed requests within the care management system
• Make outbound calls to follow up on discharge information or request updated clinical information as necessary for concurrent review
• Screen inquiries to determine the services that require certification at the time of the inquiry
• Obtain clinical information and forward the caller to the clinical staff for completion of the review
• Provide certification based upon scripted clinical algorithms or benchmark Length of Stay
• Collaborate and effectively communicate with internal and external partners
• Stay up to date on Summary Plan Documents and other related resources related to service requests
• Ensure applicable URAC standards, Confidentiality/HIPAA standards, and internal policies, practices, and productivity metrics are met
• Performs other related duties as assigned by supervisor
• Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

Bilingual Intake Coordinator

Data Scientist

• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data.
• Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy.
• Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions.
• Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients.
• Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections.
• Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability.
• Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs.
• Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements.
• Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities.

Healthcare Data Scientist – Claims, Quality, Provider Performance

Implementation Specialist

• Support the client implementation process by coordinating tasks, managing timelines, and ensuring clients have a positive onboarding experience.
• Assist with the rollout of new products and services for clients by working closely with cross-functional teams to facilitate smooth integration.
• Respond to and process client configuration requests in collaboration with the Client Success team to meet client needs and improve platform utilization.
• Participate in process improvement efforts by identifying opportunities and contributing feedback to enhance implementation practices.
• Ensure compliance with company standards and client requirements throughout implementation activities.
• Maintain accurate project documentation, task updates, and status reports in systems such as Salesforce, Wrike, Trello, and other internal tools.
• Track and report project progress, escalating issues or risks to senior team members as needed.
• Perform other duties as assigned.

Client Implementation Manager

Data Analyst

• Analyze medical and pharmacy claims to develop and maintain data products that support pricing, quality, and compliance tools
• Apply advanced models and queries to resolve data issues, support client inquiries, and improve internal analytics tools and workflows
• Use tools such as SQL, Python, Spark, and Databricks to transform complex datasets into actionable insights and clear recommendations
• Partner with Data Engineering, Web Development, and other Analytics teams to design, deploy, and sustain complex code and workflows
• Collaborate with different departments to investigate and resolve ad hoc cases, addressing client-specific inquiries and internal requests with accurate, data-driven responses
• Follow production-level code release processes while driving the improvement and evolution of departmental workflows, analytics tools, and documentation
• Continuously monitor data quality and performance, identifying trends, anomalies, and opportunities for improvement
• Demonstrate initiative by independently managing complex tasks while contributing to a collaborative, team-oriented environment
• Support broader strategic initiatives by delivering high-quality analysis that informs decision-making and advances organizational goals

Senior Healthcare Data Analyst

• Lead internal audits, operational reviews, and risk assessments, including pre- and post-implementation evaluations.
• Manage the development, revision, and documentation of compliance policies, procedures, and training materials.
• Serve as the primary intake for compliance-related questions, Hotline submissions, and incident reports; provide timely, well-reasoned recommendations.
• Collaborate with leadership on mitigation plans and root cause analysis tied to regulatory or contractual noncompliance.
• Represent Compliance in client-facing meetings, audits, and business reviews.
• Monitor and interpret applicable laws, regulations, and delegation requirements (ERISA, HIPAA, CMS, HHS-OCR, DOL, URAC, NCQA), translating them into practical guidance.
• Review healthcare claims, coding structures (ICD-10, DRG, CPT), and workflows to identify risks and ensure compliance.
• Support vendor and third-party compliance documentation, including audit coordination and follow-up.
• Maintain compliance logs, records, and investigation documentation.
• Assist with board-level reporting, internal committee materials, and responses to payer/client audits of delegated functions.
• Serve as a trusted compliance partner to operational, legal, and product teams.
• Contribute to scalable compliance processes, onboarding, and training for future compliance staff.

Senior Regulatory Compliance Analyst

• Design and maintain high-performance data pipelines, automate processes, and implement scalable data storage solutions using Databricks on Azure
• Collaborate with cross-functional teams to enhance data processing, integrate new data sources, and apply best practices in data lake architecture
• Drive continuous improvement initiatives to enhance data processing capabilities across the organization
• Design and implement efficient, high-performance data ingestion pipelines from diverse sources utilizing Databricks on Azure
• Develop and maintain reliable data pipelines, automating manual processes to improve efficiency and scalability
• Collaborate with the Data Engineering team to design and support robust processes for loading data into relational, dimensional, and NoSQL database systems
• Implement best practices in data lake architecture to ensure scalable, standardized, and optimized data storage and processing solutions
• Partner with cross-functional teams to identify, evaluate, and acquire new data sources that align with organizational objectives
• Actively participate in agile development processes, contributing to sprint planning, refinement, and delivery of high-quality solutions

Senior Data Engineer

Security Engineer

• Lead and maintain SOC 2 and HITRUST compliance programs, ensuring evidence is current and aligned with control requirements
• Utilize Vanta to automate evidence collection, track remediation tasks, and maintain real-time compliance visibility across systems
• Act as the primary liaison with auditors and assessors during certification reviews
• Oversee enterprise compliance with NIST, SOC 2, and HITRUST frameworks, ensuring consistent control implementation and documentation
• Continuously improve audit readiness processes and coordinate internal control testing
• Lead the information security risk assessment program, including periodic evaluation of internal systems, business processes, and third-party vendors
• Manage and track client and third-party security risk assessment requests; coordinate internal teams to ensure accurate and timely responses
• Log all requests in a centralized system with requester details, completion date, and response metrics
• Support the development and tracking of mitigation plans for identified vulnerabilities or compliance gaps
• Design, implement, and oversee the Business Continuity and Disaster Recovery (BC/DR) program
• Conduct tabletop exercises and live failover tests with IT and business leaders to validate operational resilience
• Ensure recovery documentation and communication protocols align with corporate and regulatory requirements
• Partner with IT Service Operations and third-party providers to manage security and privacy awareness programs
• Measure training effectiveness and engagement metrics; drive continuous improvement
• Promote a security-first culture across all business units
• Mentor Security Assurance Analysts, providing guidance on audit preparation, control validation, and risk mitigation activities
• Review and advise on security design for IT projects to ensure alignment with established policies and standards
• Foster collaboration between IT, Legal, Compliance, and business teams to maintain enterprise-wide alignment on security priorities
• Perform additional Security Assurance duties as assigned by leadership.

Senior Security Assurance Analyst

Systems Engineer

• Collaborate with business partners to gather, interpret, and document business requirements, including data discovery and analysis.
• Participate in planning meetings to represent engineering teams and translate business needs into technical deliverables.
• Act as a liaison between business and development teams, aligning stakeholders on priorities and supporting roadmap planning with product managers.
• Develop clear and comprehensive Business Requirement Documents (BRDs), including process mapping, gap analysis, and SWOT analysis.
• Support project management activities for assigned initiatives.
• Identify opportunities for process automation and efficiency improvements.
• Generate reports to analyze and monitor business performance.
• Troubleshoot application or process issues, document findings, and recommend solutions.
• Design and execute test plans, scenarios, and cases for system, user acceptance, and integration testing.
• Evaluate test results, report issues, and collaborate with development teams to resolve defects.
• Ensure adherence to company policies, procedures, and compliance standards.
• Perform additional duties as assigned.

Business Systems Analyst

• Lead strategic development of a unified member engagement function across Valenz to manage communications and routing
• Oversee staged rollout of strategic initiatives, ensuring alignment with business priorities and collaboration with service-line leaders
• Partner with stakeholders to design and implement member-facing technology strategy (telephony, asynchronous communications, internal tools)
• Develop and execute a data management strategy to leverage insights for proactive outreach and member steerage
• Provide operational oversight of the Member Engagement team including workflow design, training, staffing strategy, and performance metrics
• Drive continuous improvement initiatives to scale member engagement capabilities and deliver outcomes tied to business objectives
• Foster cross-functional partnerships with effective communication and change management practices
• Build and maintain client relationships specific to member engagement ensuring alignment and satisfaction
• Manage budgets for the member engagement function and balance resources with strategic priorities
• Perform other duties as assigned

Vice President, Member Solutions

• Analyze medical and pharmacy claims to develop and maintain data products that support pricing, quality, and compliance tools.
• Apply advanced models and queries to resolve data issues, support client inquiries, and improve internal analytics tools and workflows.
• Use tools such as SQL, Python, Spark, and Databricks to transform complex datasets into actionable insights and clear recommendations.
• Partner with Data Engineering, Web Development, and other Analytics teams to design, deploy, and sustain complex code and workflows.
• Collaborate with different departments to investigate and resolve ad hoc cases, addressing client-specific inquiries and internal requests with accurate, data-driven responses.
• Follow production-level code release processes while driving the improvement and evolution of departmental workflows, analytics tools, and documentation.
• Continuously monitor data quality and performance, identifying trends, anomalies, and opportunities for improvement.
• Independently manage complex tasks while contributing to a collaborative, team-oriented environment and support broader strategic initiatives.
• Perform other duties as assigned.

• Lead, mentor, and develop a team of Business Systems Analysts, setting clear goals and performance standards
• Conduct coaching sessions, performance reviews, and career development planning to build a high performing team
• Serve as the primary liaison between business stakeholders, product owners, and technical teams
• Oversee elicitation, documentation, validation, and translation of business needs into functional specifications, user stories, and acceptance criteria
• Collaborate with product and project managers to manage work intake, prioritize initiatives, and support delivery timelines
• Ensure adherence to business analysis best practices, industry standards, and agile methodologies (Scrum/Kanban)
• Evaluate and enhance business processes, workflows, and system functionality to improve efficiency and scalability
• Establish and maintain standard operating procedures, templates, and tools for consistent analysis
• Partner with technical teams (Data Engineering, Application Development) to understand system capabilities, constraints, and integration requirements
• Provide guidance on data mapping, workflow design, and system integrations
• Support onboarding and training of analysts on tools and platforms (Databricks, Azure DevOps, Jira, Confluence)
• Monitor project progress, identify risks and dependencies, and recommend mitigation strategies
• Facilitate workshops, ideation sessions, and requirement review meetings with cross-functional teams
• Contribute to enterprise initiatives and partner with leadership to plan team growth and training programs
• Perform other related duties as assigned

Manager, Business Systems Analysts

• Analyze medical and pharmacy claims to develop and maintain data products that support pricing, quality, and compliance tools
• Apply advanced models and queries to resolve data issues, support client inquiries, and improve internal analytics tools and workflows
• Use tools such as SQL, Python, Spark, and Databricks to transform complex datasets into actionable insights and clear recommendations
• Partner with Data Engineering, Web Development, and other Analytics teams to design, deploy, and sustain complex code and workflows
• Collaborate with different departments to investigate and resolve ad hoc cases and client-specific inquiries
• Follow production-level code release processes while driving the improvement and evolution of departmental workflows, analytics tools, and documentation
• Continuously monitor data quality and performance, identifying trends, anomalies, and opportunities for improvement
• Independently manage complex tasks while contributing to a collaborative, team-oriented environment and support broader strategic initiatives
• Adhere to company security protocols, maintain a quiet workspace, and ensure reliable internet connectivity as required for remote work

Senior Healthcare Analyst

• Work hands-on with large, complex healthcare claims and provider datasets to ensure data accuracy and integrity
• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data
• Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy
• Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions
• Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients
• Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections
• Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability
• Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs
• Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements
• Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities
• Identify and resolve data issues using SQL and Python, apply statistical methods, and deliver clear, actionable insights to support decision-making across the organization

Healthcare Data Analyst – Claims, Quality and Provider Performance

• Define and execute integrated strategy for Provider Solutions combining VPoint, EPStaffCheck, Valenz Assurance, and Quantros
• Lead cross-business initiatives to enhance coordination and operational alignment across service lines
• Establish shared KPIs, operating models, and systems to optimize delivery and improve scalability
• Champion technology platforms and automation strategies to enhance client experience and increase operational efficiency
• Map end-to-end client lifecycle to identify bundled offerings, cross-sell strategies, and value expansion
• Partner with Sales, Product, and Marketing to design and deliver unified solutions
• Serve as strategic executive sponsor for top-tier provider and payer relationships
• Lead a multidisciplinary team across operations, strategy, and client delivery; attract, retain, and develop high-performing talent
• Monitor regulatory and market trends to evolve services and maintain alignment with CMS, NCQA, HIPAA, and payer expectations
• Evaluate adjacent service lines, strategic partnerships, and potential M&A opportunities
• Report to Chief Operating Officer with full accountability for Provider Solutions delivery and quality outcomes

Senior Vice President, Provider Solutions

• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data
• Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy
• Design, develop, and maintain retrospective models for historical performance analysis and predictive models to identify high-risk patients
• Translate complex analytical findings into clear, actionable insights for internal stakeholders and external clients
• Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity and identify anomalies
• Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability
• Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies
• Investigate data quality issues, conduct root cause analysis, document findings, and deliver recommendations for process improvements
• Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions
• Maintain adherence to security protocols (VPN, secure passwords, company-approved devices/software) and HIPAA compliance

Data Scientist, Quality

Onboarding Specialist

• Own and manage the full implementation process for new clients, ensuring a seamless and efficient onboarding experience.
• Lead the launch of new Valenz products and services with existing clients, coordinating across internal departments for successful integration.
• Serve as the main point of contact throughout the implementation lifecycle, building strong relationships with clients and internal stakeholders.
• Support ongoing client configuration requests in partnership with the Client Success team to ensure long-term satisfaction and optimal platform use.
• Identify and implement process improvements that make current and future implementations more scalable, efficient, and client-friendly.
• Communicate status updates, next steps, and potential risks clearly and proactively across all levels of the organization.
• Maintain accurate and up-to-date project documentation using internal tools like Salesforce, Wrike, and Trello.
• Guide each implementation from start to finish—managing schedules, driving collaboration across teams, anticipating and resolving issues, and ensuring a smooth transition to Client Success.

Client Onboarding Manager

• Own and manage the full implementation process for new clients, ensuring a seamless and efficient onboarding experience.
• Lead the launch of new Valenz products and services with existing clients, coordinating across internal departments for successful integration.
• Serve as the main point of contact throughout the implementation lifecycle, building strong relationships with clients and internal stakeholders.
• Support ongoing client configuration requests in partnership with the Client Success team to ensure long-term satisfaction and optimal platform use.
• Identify and implement process improvements that make current and future implementations more scalable, efficient, and client-friendly.
• Communicate status updates, next steps, and potential risks clearly and proactively across all levels of the organization.
• Maintain accurate and up-to-date project documentation using internal tools like Salesforce, Wrike, and Trello.