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AVP, Data & Analytics - Clinical informatics/Risk and Quality - Remote

Role overview

Qualifications

  • 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

Responsibilities

  • 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.

About the company

Molina Healthcare logo

Molina Healthcare

Health Insurance (Payers)

Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

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.

JOB QUALIFICATIONS

Required Education

Bachelor’s Degree in business administration or related field

Required 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 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.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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