• Integrate clinical and medical data with automated technologies to support healthcare operations and informatics • Act as a liaison between clinical expertise, data systems, and regulatory standards to ensure compliance and improve service delivery • Evaluate system performance, validate workflows, and drive process improvements that enhance provider and patient experiences while reducing compliance risk • Submit IT data requests, conduct validity testing, perform quality check processes, manage escalations, contribute to process improvements, and communicate updates to key stakeholders • Analyze prior authorization and code set data to ensure alignment with clinical guidelines, regulatory standards, contracts, and operational requirements • Partner with operations, IT, and vendors to implement and validate clinical decision rules and workflows that support strategic and regulatory objectives • Identify opportunities to enhance automation, reduce provider friction, and improve service turnaround times through collaboration with internal teams and external partners • Monitor data quality and develop reporting tools for leadership and compliance purposes • Translate complex clinical and data insights into actionable strategies • Evaluate system enhancements and participate in testing and validation activities to ensure successful implementation and continuous improvement