Jobs at Alignment Healthcare

Performs actuarial analyses supporting Medicare Advantage pricing, forecasting, reserving, risk adjustment, bid development, and financial performance management. Analyzes claims, utilization, membership, risk scores, and provider data; develops models, dashboards, reports, and actuarial exhibits; validates reserves and financial results; evaluates business and regulatory impacts; and communicates recommendations to actuarial leadership and cross-functional partners. Participates in the Actuarial Development Program and provides technical guidance to junior analysts.

Leads analytics strategy, reporting, and data product delivery while managing an analytics team and portfolio. Designs scalable solutions, performs complex analysis, validates data, resolves issues, and provides executive reporting. Establishes analytics standards, roadmaps, prioritization, and operating processes; partners across operations, clinical, finance, compliance, and technology. The role improves insight quality and speed, reduces manual work, strengthens data trust, and supports business decision-making.

Leads strategic HR partnership for assigned business units, translating growth and operational goals into workforce planning, talent strategy, organizational design, change management, leadership development, and people analytics. Advises senior leaders, facilitates talent reviews and succession planning, resolves complex employee relations matters, and partners with HR centers of excellence. The role supports scaling within a regulated healthcare environment and requires strong HRIS, workforce analytics, organizational effectiveness, and employment law expertise.

Leads the architecture, implementation, and operation of enterprise data governance platforms covering metadata, master data, data quality, lineage, and observability. Integrates governance capabilities into cloud data platforms and pipelines, automates workflows, establishes technical standards, and supports auditability and traceability. Partners with data engineering, cloud infrastructure, enterprise architecture, and governance teams to deliver scalable, secure solutions.

Develop member-level predictive models and longitudinal analyses for CMS Health Outcomes Survey measures and Medicare Advantage Star Ratings. Analyze survey drivers, trajectories, sampling, response rates, case-mix adjustments, and statistical significance. Build data pipelines and dashboards, validate methodologies, deploy models with engineering teams, and translate findings into clinical and operational interventions. Collaborate with Stars, clinical, care management, compliance, legal, and survey vendor stakeholders to ensure CMS-aligned outcomes and reporting.

Leads enterprise transformation, strategic planning, capital investment governance, portfolio management, process improvement, and total cost of care initiatives for a Medicare Advantage health plan. Partners with executives to align investments, improve operational performance, reduce costs, enhance member and provider experiences, support regulatory readiness, and drive organizational change. Builds and leads teams responsible for strategy execution, program management, business analysis, and transformation delivery.

Build and deploy production AI/ML systems, distributed services, integrations, automation pipelines, and MLOps infrastructure in a regulated healthcare environment. Responsibilities include cloud-native architecture, legacy and multimodal data integration, Docker and Kubernetes deployment, ETL orchestration, RPA, LLM and RAG workflows, Databricks model productionization, monitoring, cost optimization, and responsible AI practices. Collaborate with AI, data, product, clinical, and engineering teams.

Develop predictive models, customer segmentation, automated data pipelines, and analytics supporting CAHPS, HOS, and Medicare Advantage Stars strategy. Collaborate with engineering, clinical, compliance, coding, and legal teams to ensure CMS-aligned outputs. Analyze complex healthcare data, communicate insights to stakeholders, support dashboards and reporting, and help standardize AI-readiness workflows. The role requires advanced machine learning, programming, statistical analysis, and healthcare quality modeling expertise.

Leads enterprise-wide capital planning, investment governance, strategic resource allocation, portfolio management, and investment performance evaluation for a Medicare Advantage health plan. Partners with executive leadership and Finance, IT, Operations, Clinical, Compliance, and PMO teams to prioritize investments, assess ROI, manage forecasts, support transformation and expansion initiatives, and report to executives and the Board. Builds and leads the Capital Planning Office.