Alignment Health
Healthcare
AVP,MedicareQualityAnalytics
Neural analysis suggests this role is
optimal for Senior candidates.
“AVP, Medicare Quality Analytics at Alignment Health. Skills: Advanced analytics, Healthcare quality measurement, Predictive modeling, Data science, Data strategy, Star Ratings Program analytics, Machine learning models, Statistical methods, Team leadership. 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”
What You'll Achieve.
Drive quality performance for the Star Ratings Program; Predict and optimize performance on the Star Ratings Program; Generate actionable insights; Shape the data strategies that directly influence quality outcomes; Ensure technical and strategic excellence
Industry & Context.
Deconstructing complex business and operational problems and designing effective, sustainable technical solutions
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions., While performing the duties of this job, the employee is regularly required to talk or hear., The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or and reach with hands and arms., The employee frequently lifts and/or moves up to 10 pounds., Specific vision abilities required by this job include close vision and the ability to adjust focus.
What They're Looking For.
Must Have
Minimum 10+ years data science, data engineering, or a related field, Proven track record of designing and executing large-scale, complex data solutions, Significant experience in a leadership capacity, 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, 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, Technical & Domain Expertise, Healthcare & Stars Domain Knowledge: Required understanding of Medicare Advantage, the CMS Star Ratings Program, HEDIS measures, CAHPS/HOS surveys, and pharmacy data (PDE), Advanced Modeling & Statistical Strategy: The ability to direct and apply sophisticated statistical and machine learning methods to solve critical business problems, Analytical Data Architecture & Engineering: Oversight of the data preparation process, including the strategic design of datasets, advanced feature engineering, and ensuring the integrity of the data used for all modeling and reporting, Technical Leadership & Implementation: Expert-level proficiency in Python and advanced SQL, Executive Translation: The ability to distill highly complex data concepts, challenges, and technical jargon into clear, concise summaries, Strategic Thinking: Capacity to develop a long-term vision and roadmap that aligns with business objectives, Stakeholder Management & Influence: Proven ability to build consensus and foster relationships with a diverse range of stakeholders, Thought Leadership & Mentorship: The ability to lead through influence, mentor technical staff, and champion best practices, Problem-Solving: A pragmatic approach to deconstructing complex business and operational problems and designing effective, sustainable technical solutions
Nice to Have
10+ years’ experience in Medicare Advantage Plans, 10+ years’ experience in a technical leadership position in a healthcare environment, Master’s degree in one of the above fields
What You'll Do.
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
Translate model outputs and complex datasets into actionable member
and measure-level insights
Partner with cross-functional teams to embed these insights into clinical outreach
and member engagement workflows
Own the end-to-end development of forecasting models for the Star Ratings Program
Develop and maintain performance monitoring tools and dashboards
Serve as the organization's senior data science subject matter expert on all Star measures (e.g.
Translate complex CMS methodology into technical data requirements
Support regulatory reporting and CMS audit readiness through rigorous data validation
Serve as the primary analytics partner to clinical
Present complex data science findings and model outcomes to executive audiences
Lead and mentor a dedicated team of data scientists and analysts
Promote best practices in statistical modeling
How You'll Work.
Team & Collaboration
Work closely with leaders across clinical, business, and operational departments; Partner with cross-functional teams; Serve as the primary analytics partner to clinical, quality, and business leaders; Build consensus and foster relationships with a diverse range of stakeholders, including clinical leaders, business executives, IT teams, and compliance officers
Communication Scope
Translate complex data science findings into effective business interventions; Present complex data science findings and model outcomes to executive audiences, clearly communicating the connection to business objectives and strategic value; Distill highly complex data concepts, challenges, and technical jargon into clear, concise summaries; Articulate the business value and strategic implications of ‘technical’ decisions to non-technical executives and stakeholders
Full Job Description
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 learni
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