AVP, Medicare Quality Analytics

Requirements

• Required:
• Minimum 1 0 + 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 Rating s 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 .
• Preferred:
• 10 + years' experience in Medicare Advantage Plans
• 10 + years' experience in a technical leadership position in a healthcare environment
• Education:
• Required: Bachelor's degree in Health Informatics , Computer Science, Data Science, Business Analytics or related quantitative field .
• Preferred: Master's degree in one of the above fields
• Specialized Skills:
• Technical & Domain Expertise
• Healthcare & Stars Domain K

Benefits

Additional Information

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Associate Vice President (AVP), Data Science & Analytics - Medicare Quality, is a senior leadership role responsible for the strategy and execution of advanced analytics that drive quality performance for the Star Ratings Program. This role is ideal for a senior-level data scientist with deep experience in healthcare quality measurement, predictive modeling, and data-driven strategy. This individual will serve as the principal architect of the organization's Star Ratings analytics ecosystem, responsible for developing predictive models, generating actionable insights, and shaping the data strategies that directly influence quality outcomes. This role requires a leader who blends hands-on data science expertise with strategic vision, acting as both a primary technical authority and a key business advisor. The AVP will work closely with leaders across clinical, business, and operational departments to translate complex data science findings into effective business interventions. This includes owning forecasting models, leading exploratory analysis to uncover new performance levers, and mentoring a team of analytics professionals to ensure technical and strategic excellence. Job Duties/Responsibilities: Data Modeling & Strategy : 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. Actionable Insight Generation : 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. Forecasting & Performance Monitoring : 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. Subject Matter Expertise & Compliance : Serve as the organization's senior data science subject matter expert on all Star measures (e.g., HEDIS, CAHPS, HOS, Part D). Translate complex CMS methodology into technical data requirements and support regulatory reporting and CMS audit readiness through rigorous data validation. Executive & Cross-Functional Partnership : Serve as the primary analytics partner to clinical, quality, and business leaders, helping them interpret data and make informed decisions. Present complex data science findings and model outcomes to executive audiences, clearly communicating the connection to business objectives and strategic value. Team Leadership & Development : Lead and mentor a dedicated team of data scientists and analysts. Promote best practices in statistical modeling, coding, data wrangling, and visualization to foster a culture of technical excellence and data-driven inquiry. Other Duties as Assigned Job Requirements :

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