AI & ML) - REMOTE

Molina Healthcare•Long Beach, CA

31d•Remote

About The Position

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.

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.

Nice To Haves

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

Responsibilities

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 (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.
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.