AVP, Medicare Quality Analytics

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.

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.

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.

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.

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.

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.

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.

• Required:
  • Minimum 10+ 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 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.
  • 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

• 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

• 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. This includes overseeing model selection, validation, and interpreting results to guide high-level strategic decisions.
• Analytical Data Architecture & Engineering:
  Oversight of the data preparation…