United States
1 month ago

Job Overview

Job Type
Full Time
Pay
Not disclosed

Job description

Location:
United States
Work arrangement:
Remote

Role Summary

Direct comprehensive data and analytics initiatives to enhance payer strategy, operational excellence, and clinical outcomes across Medicare, Medicaid, and Commercial populations. Oversee enterprise reporting, integrate pragmatic AI/ML solutions, and specialized clinical analytics while fostering cross-functional partnerships and robust data governance. Develop high-performing teams that transform complex data into trusted, actionable insights to drive financial and organizational growth.

KNOWLEDGE/SKILLS/ABILITIES

Lead payer analytics strategy to improve quality, risk adjustment, clinical outcomes, operational performance, and business results across Medicare, Medicaid, Marketplace, and Dual populations.

Oversee enterprise reporting and business intelligence, delivering trusted insights, KPIs, dashboards, and self-service analytics that support strategic and operational decision-making.

Direct Quality, Risk Adjustment, and Clinical Analytics, including HEDIS®, Star Ratings, RAF performance, population health, care management, utilization management, and provider performance initiatives.

Leverage AI, machine learning, and advanced analytics to identify opportunities, predict outcomes, automate decision support, and accelerate business value realization.

Partner with data, technology, and business leaders to ensure analytics solutions are built on trusted data, modern platforms, and strong governance practices.

Build and develop high-performing analytics teams while translating complex data into actionable insights that improve member outcomes, financial performance, and organizational growth.

Requirements

JOB QUALIFICATIONS

Required Education

Bachelor’s Degree in business administration or related field

  • 10 years+ operational experience
  • 5 years+ in supervisory and/or management experience in Managed Care or Medicare related field
  • 5 years+ in SQL, programming skills, relational database, and financial analysis skills
  • 3 years+ in implementing AI and ML augmented analytic solutions across payer landscape

Preferred Education

Master's Degree in Business Administration or related field

  • To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
  • Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Role:
AVP, Data & Analytics - Clinical informatics/Risk and Quality - Remote
Job Type:
Full Time

Company profile

Molina Healthcare

molinahealthcare.com

Molina Healthcare, Inc. is an American managed care company that provides health insurance to individuals through government programs such as Medicaid and Medicare. It was started by C. David Molina, an emergency room physician in Long Beach, California, who opened a primary care clinic to treat the lowest-income patients regardless of their ability to pay. His sons J. Mario Molina and John Molina later ran and expanded the company, and Joseph Zubretsky, a former CFO of Aetna, became president and CEO in October 2017.

Company Size
10,000 - 50,000 employees
Headquarters
Long Beach, California, United States
Founded
1980
Founders
C. David Molina
Funding Stage
Public

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