AVP, Risk Adjustment Analytics

Job Description

Job Summary
The AVP, Risk Adjustment Analytics is responsible for understanding, analyzing, and summarizing data for internal and external stakeholders of the risk adjustment department. The AVP identifies trends and data nuances, builds predictive data models and rules to maximize the insights provided by data, and advises the technical and development teams on ways to improve system architectures based on future data modeling needs. This position within the Risk Adjustment team will be a key contributor in developing risk adjustment models to improve health plan financial performance in the Medicare, Medicaid, and Affordable Care Act (ACA) lines of business.


Knowledge/Skills/Abilities

• Lead, attract and develop outstanding talent to ensure achievement of objectives
• Extract and analyze large business data sets to understand past, current and future trends and communicate in a format explainable to end user to help make business decisions.
• Supporting architectural and data warehouse design of both current and future environments.
• Create and execute recurring and ad hoc queries/reports/dashboards from internal systems and other various systems utilizing SAS, SQL, Excel, Access, or other programs/languages.
• Create analytical models and summary level presentations for customers and stakeholders.
• Foster and maintain relationships with the Operations to understand and explain business and technical issues by mining data and to provide or recommend viable solutions.
• Work with technology team to improve on the timeliness of data and availability.
• Solve for automating processes necessary to analyze data.
• Maintain ongoing communication with the VP regarding issues/nuances that arise during review processes.
• Maintain compliance with all policies and procedures.
• Adhere to all confidentiality and HIPAA requirements as outlined within Policies and Procedures in all ways and at all times with respect to any aspect of the data handles or services rendered in the undertaking of the position.
• Fulfill those responsibilities and/or duties that may be reasonably provided by Molina for the purpose of achieving operational and financial success of the Company..

Job Qualifications


Required Education

• Master's degree (Ph.D. preferred) in a field that includes the study of Statistics, Computer Science, Healthcare, Finance, or similar field of study

Required Experience

• 8 years of experience working in a data or analytical roles supporting predictive modeling for healthcare data.
• Must be proficient in the use of MS Excel (Macros, V-Look-ups, Pivot Tables, Formulas), BI tools (Tableau, QlikView, Cognos, Business Objects, etc.) database\data languages (SQL, SAS, Access, VBA, etc.), and PowerPoint.
• Good presentation and communication skills, with the ability to develop presentations that effectively communicate complex analytical results to non-technical business teams.
• Knowledge of statistics and research methodology – including predictive modeling and measurement theory.
• Experience with large databases, statistical software packages, and/or applications for data visualization and reporting to end users is necessary.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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