Clinical Informatics & Ontology Lead

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.

Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

Overview: 

The Clinical Informatics & Ontology Lead will serve as the enterprise subject matter expert for clinical terminology, semantic normalization, ontology strategy, and clinical concept governance within the Enterprise Data Informatics team, reporting directly to the AVP, Informatics. This role is responsible for leading the design, governance, and operationalization of clinical ontologies, reference data, value sets, and terminology services that underpin Inovalon's real-world data products, data normalization strategy, and data quality framework. 

Duties and Responsibilities: 

• Clinical Ontology Strategy: Lead the strategy, governance, and maintenance of clinical ontologies and terminology assets, including ICD-10-CM, CPT, HCPCS, SNOMED CT, LOINC, RxNorm, and internal reference tables, ensuring accuracy, currency, traceability, and alignment with data product needs.


• Terminology Ownership: Serve as the primary Informatics lead for normalization and terminology services; translate business, clinical, and product requirements into terminology configuration, mapping, and implementation priorities.


• Clinical Normalization Leadership: Lead and refine clinical normalization approaches for structured, semi-structured, and unstructured healthcare data, ensuring that source data are mapped to standardized codified elements with clinical fidelity and reusable governance.


• Cross-Functional Collaboration: Collaborate closely with Data Engineering, Product, and Clinical teams to ensure that data specifications are accurately implemented, and downstream data products reflect high-fidelity source data.


• Data Quality Rule Design: Define terminology-driven data quality rules, semantic validation checks, and normalization benchmarks; partner with the Data Quality & Analytics team to identify gaps, drift, obsolete codes, mapping failures, and downstream product impacts.


• Pipeline Modernization and Knowledge Graph Support: Lead Informatics input into the migration of legacy reference tables to scalable terminology services, ontology management workflows, and, where applicable, knowledge graph capabilities.


• Data Asset and Source Assessment: Evaluate new and existing data assets for clinical depth, code specificity, normalization readiness, and semantic fit for real-world data (RWD) and related products; prepare structured recommendations for leadership review.


• Governance and Documentation: Maintain documentation of ontology decisions, mapping assumptions, value set definitions, version changes, and downstream dependencies to support auditability, release readiness, and cross-functional transparency.


• Maintain compliance with Inovalon's policies, procedures, and mission statements.


• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position.


• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company.


• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.


• We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such. 

Job Requirements: 

• 10+ years of experience in healthcare data, clinical informatics, terminology management, ontology governance, clinical data normalization, or a related field with a Bachelor's degree required; or


• 7+ years of experience in healthcare data, clinical informatics, terminology management, ontology governance, clinical data normalization, or a related field with a Master's degree required.


• Terminology Expertise: Deep hands-on expertise with ICD-10-CM, CPT, HCPCS, SNOMED CT, LOINC, RxNorm, clinical concept modeling, value sets, crosswalks, and terminology lifecycle management required.


• SQL and Data Analysis Skills: Proficiency with SQL for querying, profiling, validating, and investigating large-scale healthcare datasets, including EHR, claims, RWD, and normalized clinical data assets.


• Data Normalization and Ontology Management: Demonstrated experience designing, implementing, or governing clinical normalization workflows, semantic mappings, terminology services, reference tables, and/or ontology management platforms.


• Communication and Leadership: Ability to translate complex terminology and ontology decisions for product, engineering, clinical, governance, and executive stakeholders; ability to document decisions clearly and drive cross-functional alignment.


• Organizational Skills: Ability to manage multiple terminology, normalization, and product-support workstreams in a fast-paced, agile environment while maintaining strong version control, decision traceability, and prioritization discipline. 

 Education: 

• Bachelor's Degree in Health Informatics, Medical Informatics, Clinical Informatics, Computer Science, Health Information Management, Nursing, Pharmacy, Medicine, or a related field required.


• Master's Degree in Medical Informatics, Health Informatics, Clinical Informatics, Biomedical Informatics, or a related discipline preferred.


• Relevant professional certifications or credentials, such as AHIC, CPHIMS, RHIA, CCS, CHDA, terminology/ontology training, or equivalent experience, a plus. 

Physical Demands and Work Environment: 

• Sedentary work (i.e. sitting for long periods of time);


• Exerting up to 10 pounds of force occasionally and/or negligible amount of force;  


• Frequently or constantly lift, carry push, pull or otherwise move objects and repetitive motions;


• Subject to inside environmental conditions; and


• Travel for this position will include less than 10-15% as needed to perform job responsibilities.