Director, Data Management (EIM / Health Plan Analytics / AI & ML) - REMOTE
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Job description
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., 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.
Requirements
- 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
Benefits & conditions
- 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