Director, Data Management (EIM / Health Plan Analytics / AI & ML) - REMOTE
Molina Healthcare, Phoenix, AZ, United States
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 (FinOps) .
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.
Key Responsibilities Healthcare Data Domain Leadership
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 .
Databricks & Data Platform Modernization
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 .
AI‑Enabled Data Management
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 .
Enterprise Integration & Data Exchange
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.
FinOps & Platform Cost Management
Lead
cloud and data platform financial management (FinOps) , 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.
Delivery, Governance & Risk Management
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.
Leadership & Team Development
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.
Required Knowledge, Skills & Experience Required
10+ years of experience in healthcare data management, data engineering, or analytics , with
direct experience in a payer / managed‑care organization .
Strong understanding of
health plan operations and data , including claims, encounters, authorizations, provider, member, and clinical data.
Proven leadership experience delivering
enterprise‑scale data platforms and integrations .
Hands‑on experience with
Databricks and Azure cloud data platforms .
Experience operating in
highly regulated healthcare environments
(HIPAA, CMS, state Medicaid).
Demonstrated ability to lead
cross‑functional teams
and manage complex stakeholder relationships.
Preferred
Experience supporting
Medicaid, Medicare, Marketplace , or multi‑LOB health plans.
Experience enabling
AI/ML initiatives
in healthcare.
Strong background in
FinOps, cloud cost governance, and optimization .
Familiarity with healthcare data standards and integrations (EDI, FHIR, HL7).
Prior experience in
Data Engineering and Data Management
Leadership Expectations
Acts as a
healthcare data thought leader
within Molina.
Treats data as a
strategic enterprise asset
supporting clinical quality, regulatory compliance, and financial performance.
Drives results through
collaboration, accountability, and disciplined execution .
Promotes standardization, reuse, and long‑term sustainability of Molina’s data ecosystem. 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.
Pay Range: $117,731 - $229,576 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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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 (FinOps) .
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.
Key Responsibilities Healthcare Data Domain Leadership
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 .
Databricks & Data Platform Modernization
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 .
AI‑Enabled Data Management
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 .
Enterprise Integration & Data Exchange
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.
FinOps & Platform Cost Management
Lead
cloud and data platform financial management (FinOps) , 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.
Delivery, Governance & Risk Management
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.
Leadership & Team Development
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.
Required Knowledge, Skills & Experience Required
10+ years of experience in healthcare data management, data engineering, or analytics , with
direct experience in a payer / managed‑care organization .
Strong understanding of
health plan operations and data , including claims, encounters, authorizations, provider, member, and clinical data.
Proven leadership experience delivering
enterprise‑scale data platforms and integrations .
Hands‑on experience with
Databricks and Azure cloud data platforms .
Experience operating in
highly regulated healthcare environments
(HIPAA, CMS, state Medicaid).
Demonstrated ability to lead
cross‑functional teams
and manage complex stakeholder relationships.
Preferred
Experience supporting
Medicaid, Medicare, Marketplace , or multi‑LOB health plans.
Experience enabling
AI/ML initiatives
in healthcare.
Strong background in
FinOps, cloud cost governance, and optimization .
Familiarity with healthcare data standards and integrations (EDI, FHIR, HL7).
Prior experience in
Data Engineering and Data Management
Leadership Expectations
Acts as a
healthcare data thought leader
within Molina.
Treats data as a
strategic enterprise asset
supporting clinical quality, regulatory compliance, and financial performance.
Drives results through
collaboration, accountability, and disciplined execution .
Promotes standardization, reuse, and long‑term sustainability of Molina’s data ecosystem. 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.
Pay Range: $117,731 - $229,576 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
#J-18808-Ljbffr