AVP, Business Intelligence & Analytics Engineering

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🔥 1 minute ago

🇺🇸 United States – Remote

💵 $150k - $300k / year

⏰ Full Time

🔴 Lead

📊 Analytics Engineer

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Own the enterprise Business Intelligence, Analytics, and Data Products strategy, governance, and multi-year roadmap • Partner with clinical, financial, operational, compliance, and technology stakeholders to define KPIs and self-service analytics capabilities • Establish data product standards, governance practices, and scalable delivery frameworks • Evaluate BI and analytics technologies and lead build-versus-buy recommendations • Ensure analytics and reporting comply with HIPAA, CMS, state regulatory, and enterprise governance requirements • Lead predictive and prescriptive analytics solutions for risk adjustment, quality improvement, population health, utilization management, care gap closure, fraud detection, and other priorities • Oversee development, deployment, optimization, monitoring, and lifecycle management of advanced analytic models • Build, lead, and develop an organization of BI developers, data engineers, data scientists, ML engineers, statisticians, and analytics professionals • Own the enterprise AI/ML platform strategy, architecture, governance, and evolution • Lead enterprise AI and generative AI use cases, including LLM and RAG solutions • Establish responsible AI governance covering model risk, fairness, explainability, bias monitoring, human oversight, ethics review, and audit readiness • Collaborate with Security, Compliance, Legal, Privacy, and Technology leadership on AI regulatory, security, auditability, and vendor risk requirements • Develop reusable AI frameworks, accelerators, governance standards, and enablement resources • Advise executive and Board-level stakeholders on analytics and AI strategy, performance, risks, opportunities, and business value • Own financial planning and budget accountability for the analytics, data science, and AI engineering portfolio • Foster innovation, continuous learning, experimentation, and responsible data- and AI-driven decision-making

🎯 Requirements

• Bachelor's degree in Computer Science, Statistics, Mathematics, Biomedical Informatics, or a related quantitative field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Ten (10) years of progressive experience in data analytics, data science, or AI/ML engineering required • Four (4) years in a senior leadership role managing technical teams required • Advanced proficiency in Python, SQL, and statistical programming languages such as R or SAS • Experience with Spark/PySpark and modern machine learning frameworks • Familiarity with claims, clinical, HEDIS/Stars, HCC, and member data models • Understanding of AI/ML and MLOps, including model lifecycle management, monitoring, CI/CD, experiment tracking, generative AI, LLMs, prompt engineering, RAG architectures, and vector databases • Knowledge of healthcare and managed care data ecosystems, including HL7/FHIR, ICD-10/CPT, NCQA HEDIS, CMS risk adjustment, and applicable regulations • Demonstrated leadership, talent development, organizational management, executive communication, and cross-functional collaboration capabilities • Experience in managed care, health plan, or health insurance environments preferred • Production AI/ML solutions experience in regulated, privacy-sensitive environments preferred • Databricks or equivalent modern lakehouse platform experience strongly preferred • Vendor evaluation, contract negotiation, and technology partnership management experience preferred • Data governance experience including cataloging, lineage, quality monitoring, and access control in a HIPAA-regulated context preferred • Ability to travel as required by business needs • No licensure or certification required

🏖️ Benefits

• Remote work arrangement • Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support • Professional development, career development, and technical skill advancement opportunities