Director, Data Management; EIM​/Health Plan Analytics​/AI & ML - REMOTE

Director, Data Management (EIM) Job Summary

The Director, Data Management is a senior leadership role within Molina Healthcare responsible for enterprise data management strategy, delivery, and modernization across core health plan domains
. This role leads the design, integration, and operation of data platforms that support Medicaid, Medicare, Marketplace, and other payer lines of business
, with a strong emphasis on Databricks‑based lakehouse architecture, AI‑enabled data management, and cloud platform cost optimization (Fin Ops).

This leader owns end‑to‑end data domain delivery
, including ingestion, integration, governance, quality, analytics enablement, and operational reliability for critical healthcare data such as claims, clinical, provider, member, authorizations, encounters, quality, and financial data
. The role partners closely with Clinical, Operations, Finance, Compliance, Security, and Enterprise Architecture to ensure data solutions are secure, compliant, scalable, and aligned to Molina’s business objectives and regulatory obligations
.

The Director balances near‑term delivery commitments with long‑term platform strategy, ensuring Molina’s data ecosystem enables analytics, reporting, regulatory submissions, value‑based care, and AI/ML use cases.

• Lead delivery and ongoing management of core payer data domains
  , including but not limited to:
  • Claims, Encounters, Authorizations
  • Clinical and Utilization Management data
  • Provider, Network, and Contract data
  • Member, Eligibility, and Enrollment data
  • Quality, HEDIS, and Regulatory reporting data
• Establish clear data domain ownership, stewardship, and accountability models across business and IT.
• Ensure data consistency, quality, lineage, and traceability required for regulatory audits and reporting
  .

• Drive Molina’s Databricks lakehouse strategy
  , including ingestion, transformation, analytics, ML enablement, and downstream consumption.
• Lead modernization from legacy data warehouses, marts, and custom pipelines to cloud‑native, scalable data platforms
  .
• Define and enforce platform standards for performance, security, availability, resiliency, and operational excellence
  .

• Enable AI and ML‑ready data foundations
  , including governed datasets, feature stores, and reusable data products.
• Promote use of automation and AI‑assisted capabilities for data quality monitoring, anomaly detection, metadata enrichment, and observability.
• Partner with analytics, reporting, and AI teams to accelerate insights that support clinical outcomes, cost management, and operational efficiency
  .

• Oversee enterprise data integration and data movement patterns
  , including batch, near‑real‑time, streaming, APIs, and industry standards (e.g., 837/835/278, FHIR where applicable).
• Ensure secure, compliant data exchanges with internal systems and external vendors, partners, and delegated entities
  .
• Establish clear ownership and operating models for inbound and outbound data pipelines.

• Lead cloud and data platform financial management (Fin Ops), including Databricks usage, storage, and compute optimization.
• Establish cost transparency, forecasting, and governance to balance performance, scalability, and cost efficiency
  .
• Drive accountability for platform usage across teams and domains.

• Partner with EPMO, business leaders, and IT stakeholders to manage roadmaps, priorities, dependencies, and delivery commitments
  .
• Ensure adherence to HIPAA, CMS, state Medicaid, and internal security and compliance requirements
  .
• Identify and mitigate data, platform, and delivery risks impacting business continuity and regulatory obligations.

• Build, lead, and mentor data engineering, platform, and integration teams
  .
• Establish clear performance expectations, metrics, and career development paths.
• Champion modern engineering practices, documentation, and operational discipline.

• 10+ years of experience in healthcare data management,…