Vālenz® Health

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

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.
• Contribute to scalable compliance processes, onboarding, and training for future compliance staff.

Senior Regulatory Compliance Analyst

Data Engineer

• 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

Vice President

• 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

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 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.