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

About the Role

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.

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.
• 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.

Requirements

• Bachelor’s Degree in business administration or related field (required).
• 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.

Qualifications

• Master's Degree in Business Administration or related field (preferred).

Pay

Pay Range: $161,914.25 - $315,732.79 per year. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.