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sqlaipayer analyticsdataquality analyticsmlrelational databaseshedisraf
Job Description
📋 Description
- Lead enterprise payer analytics strategy across Medicare, Medicaid, Marketplace, Dual, and
- Oversee enterprise reporting and BI capabilities for trusted KPIs, dashboards, and self-service
- Direct Quality, Risk Adjustment, and Clinical Analytics programs (HEDIS, Star, RAF, population
- Translate complex clinical/operational/financial data into actionable recommendations for senior
- Identify AI/ML opportunities to improve decision support and business value.
- Lead AI/ML-augmented analytics solutions across the payer environment with governance and
🎯 Requirements
- Bachelor’s degree; MBA or related master’s preferred.
- 10+ years in data/analytics/healthcare operations with increasing responsibility.
- At least 5 years in supervisory/management within managed care, Medicare, or related healthcare.
- 5+ years hands-on SQL, programming, relational databases, and financial analysis.
- 3+ years implementing AI and ML analytics in payer/healthcare settings.
- Strong knowledge of payer analytics: quality, risk adjustment, clinical analytics, population
🎁 Benefits
- Annual salary range: $161,914.25–$315,732.79 (actual compensation varies by location/experience).
- Full-time employment with executive-level opportunity to shape enterprise data and analytics
- Competitive compensation and benefits package supporting well-being.
- Opportunities to lead transformative initiatives spanning clinical informatics, quality, risk
- Chance to build high-performing teams and influence analytics capabilities enterprise-wide.
- Exposure to strategic initiatives across Medicare, Medicaid, Marketplace, Dual, and Commercial
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