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

Accountabilities:

• • Lead the enterprise payer analytics strategy across Medicare, Medicaid, Marketplace, Dual, and Commercial populations, with a focus on quality, risk adjustment, clinical outcomes, operational performance, and business results.
  • Oversee enterprise reporting and business intelligence capabilities, ensuring delivery of trusted KPIs, dashboards, reporting solutions, and self-service analytics for strategic and operational decision-making.
  • Direct Quality, Risk Adjustment, and Clinical Analytics programs, including HEDIS®, Star Ratings, RAF performance, population health, care management, utilization management, and provider performance analytics.
  • Develop and execute analytics strategies that translate complex clinical, operational, and financial data into actionable recommendations for senior leadership.
  • Identify opportunities to apply artificial intelligence, machine learning, predictive analytics, and automation to improve decision support and accelerate measurable business value.
  • Lead the implementation of AI/ML-augmented analytical solutions across the payer environment, ensuring alignment with business priorities and practical operational needs.
  • Partner with data, technology, clinical, and business leaders to ensure analytics solutions are supported by reliable data, scalable technology platforms, and effective governance.
  • Establish and strengthen data and analytics governance practices to promote data quality, consistency, transparency, and trusted enterprise reporting.
  • Develop analytics capabilities that support improved member outcomes, financial performance, quality scores, risk management, and organizational growth.
  • Build, mentor, and lead high-performing analytics teams, fostering accountability, innovation, collaboration, and continuous professional development.
  • Establish strong cross-functional partnerships and communicate complex analytical findings in a clear, concise, and actionable manner to executive and operational stakeholders.
  • Continuously evaluate analytics capabilities, emerging technologies, and market developments to identify opportunities for greater efficiency, insight, and competitive advantage.

  Requirements:

  • Bachelor’s degree in business administration or a related field is required; a Master’s degree in Business Administration or a related discipline is preferred.
  • 10+ years of operational experience, with a demonstrated record of increasing responsibility in data, analytics, healthcare operations, or related environments.
  • At least 5 years of supervisory or management experience within managed care, Medicare, or a closely related healthcare environment.
  • 5+ years of hands-on experience with SQL, programming, relational databases, and financial analysis.
  • At least 3 years of experience implementing AI- and machine-learning-augmented analytics solutions within the payer or healthcare landscape.
  • Strong knowledge of payer analytics, including quality measurement, risk adjustment, clinical analytics, population health, care management, utilization management, and provider performance.
  • Demonstrated understanding of Medicare, Medicaid, Marketplace, Dual, and Commercial healthcare populations and their associated analytics requirements.
  • Proven ability to lead enterprise-scale analytics and reporting strategies and translate data into meaningful business outcomes.
  • Strong understanding of data governance, analytics architecture, business intelligence, and modern data platforms.
  • Experience working with senior executives and cross-functional stakeholders to influence strategy and drive organizational change.
  • Strong analytical, financial, strategic-thinking, and problem-solving capabilities.
  • Excellent communication and presentation skills, with the ability to explain complex technical and analytical concepts to both technical and non-technical audiences.
  • Demonstrated leadership skills, including the ability to attract, develop, motivate, and retain high-performing analytics professionals.
  • Ability to operate effectively in a complex, fast-paced, highly regulated healthcare environment while balancing strategic priorities with execution.

  Benefits:

  • Annual salary range: $161,914.25–$315,732.79, with actual compensation varying based on factors such as geographic location, experience, education, and skill level.
  • Full-time employment with an executive-level opportunity to shape enterprise data and analytics strategy.
  • Competitive compensation and benefits package designed to support professional and personal well-being.
  • Opportunities to lead transformative initiatives spanning clinical informatics, quality, risk adjustment, AI/ML, and enterprise analytics.
  • Opportunity to build and develop high-performing teams and influence analytics capabilities at an enterprise level.
  • Exposure to strategic initiatives across Medicare, Medicaid, Marketplace, Dual, and Commercial populations.
  • Collaborative environment with close partnership across technology, data, clinical, and business leadership functions.
  • Equal opportunity workplace committed to an inclusive and respectful professional environment.