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.
Skills Required
- Bachelor's Degree in business administration or related field
- Master's Degree in Business Administration or related field
- 10+ years operational experience
- 5+ years supervisory or management experience in Managed Care or Medicare
- 5+ years experience with SQL, programming, relational databases, and financial analysis
- 3+ years implementing AI and ML augmented analytic solutions in a payer environment
- Experience directing Quality, Risk Adjustment, HEDIS, Star Ratings, RAF, population health, care management, utilization management, and provider performance initiatives
- Experience overseeing enterprise reporting, KPIs, dashboards, and self-service analytics (BI)
What We Do
Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.
_13.png)
