AVP, Medicare Quality Analytics

🕒 5 days ago

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

👥 B2C

💰 $321.1M Post-IPO Debt - Alignment Health on 2024-11

Healthcare Insurance • B2C

Alignment Health is a Medicare-focused health insurance company that offers Medicare Advantage plans and member-centered services. It provides 24/7 on-demand access to care via in-person, in-home, and mobile channels and features a concierge-style on-demand card to help members schedule appointments, arrange transportation, and answer health questions. Alignment Health partners with brokers, providers, Accountable Care Organizations (ACOs), and institutional partners, operates in multiple U. S. states (including Arizona, California, Nevada, North Carolina, and Texas), and has earned high CMS ratings and industry recognition.

📋 Description

• Lead the design, development, and continuous refinement of advanced statistical and machine learning models to predict and optimize performance on the Star Ratings Program. • Own the technical roadmap for the analytics platform, ensuring it supports current and future analytical needs. • Translate model outputs and complex datasets into actionable member, provider, and measure-level insights. • Partner with cross-functional teams to embed these insights into clinical outreach, population health, and member engagement workflows to guide targeted interventions. • Own the end-to-end development of forecasting models for the Star Ratings Program, including the design of risk-adjusted simulations. • Develop and maintain performance monitoring tools and dashboards to track and measure performance at all organizational levels. • Serve as the organization's senior data science subject matter expert on all Star measures (e.g., HEDIS, CAHPS, HOS, Part D).

🎯 Requirements

• Minimum 10+ years data science, data engineering, or a related field, with a proven track record of designing and executing large-scale, complex data solutions. • Significant experience in a leadership capacity, with demonstrated ability to set technical vision and manage teams. • In-depth knowledge of the healthcare industry, specifically Medicare Advantage and the CMS Star Ratings System. • Expert-level proficiency with modern data architecture principles, including cloud platforms (Azure), data warehousing, data lakes, and ETL/ELT processes. • Demonstrated experience establishing and managing data governance and data quality programs. • Strong understanding of data security and compliance requirements in a healthcare context. • Bachelor's degree in Health Informatics, Computer Science, Data Science, Business Analytics or related quantitative field.