Director, Data and Analytics – Payer Analytics

Job Description

AVP, Data & Analytics – Clinical informatics/Risk and Quality | Molina Healthcare

The Tone:
This is a full-time role at Molina Healthcare, located remotely across the USA. Molina Healthcare focuses on enhancing payer strategy, operational excellence, and clinical outcomes for Medicare, Medicaid, and Commercial populations. This leadership position is critical for directing comprehensive data and analytics initiatives that translate complex information into actionable insights, driving financial and organizational growth.

The TL;DR
• Role: Full Time
• Type: Full-time
• Location: Remote, USA Remote
• Pay: $161914–$315732 yearly
• Team: Leads high-performing analytics teams.
• Mission: To transform complex data into trusted, actionable insights that drive financial and organizational growth and improve member outcomes across various populations.
• Tech Stack: SQL, AI, ML, relational database

What You’ll Actually Do
• Strategy Leadership: Lead payer analytics strategy to improve quality, risk adjustment, clinical outcomes, operational performance, and business results across Medicare, Medicaid, Marketplace, and Dual populations.
• Enterprise Reporting: Oversee enterprise reporting and business intelligence, delivering trusted insights, KPIs, dashboards, and self-service analytics that support strategic and operational decision-making.
• Clinical Analytics Direction: Direct Quality, Risk Adjustment, and Clinical Analytics, including HEDIS®, Star Ratings, RAF performance, population health, care management, utilization management, and provider performance initiatives.
• AI/ML Implementation: Leverage AI, machine learning, and advanced analytics to identify opportunities, predict outcomes, automate decision support, and accelerate business value realization.
• Team & Partnership Development: Build and develop high-performing analytics teams while partnering with data, technology, and business leaders to ensure solutions are built on trusted data, modern platforms, and strong governance practices.

The Must-Haves
• Background: Bachelor’s Degree in business administration or a related field. This is a senior leadership position within data and analytics for a managed care organization.
• Experience: 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 the payer landscape.
• Skills: SQL proficiency, AI/ML implementation, financial analysis, data governance, payer analytics strategy, business intelligence, and enterprise reporting.
• Bonus: Master’s Degree in Business Administration or a related field.