Mgr-Care Management Data Analytics

Accountabilities:

• Lead the development and implementation of predictive and prescriptive analytical frameworks that support proactive decision-making and operational excellence within Care Management.
• Drive the transition from descriptive reporting toward predictive and prescriptive analytics to optimize workflows, anticipate risks, and improve member outcomes.
• Partner with Care Management leadership to identify opportunities where data science, machine learning, and advanced analytics can improve service delivery.
• Oversee statistical programming and machine learning approaches used to identify trends, member health risks, operational bottlenecks, and other actionable patterns.
• Guide the development of advanced analytical models and automated data pipelines that provide dynamic intelligence beyond traditional static dashboards.
• Ensure statistical methodologies and predictive models meet rigorous standards for accuracy, reliability, and scientific validity.
• Provide day-to-day leadership, coaching, performance management, and development for a team of data analysts.
• Assign and prioritize complex analytical workstreams while ensuring the team uses modern computational tools effectively.
• Serve as a strategic partner to IT, Business Intelligence, Quality, Clinical Operations, and other stakeholders on data architecture and advanced analytics needs.
• Translate complex statistical findings and technical outputs into clear, actionable recommendations for non-technical executives and leadership teams.
• Lead data-driven project planning, reporting initiatives, and audit preparation using predictive insights to anticipate regulatory and operational changes.
• Establish quality assurance protocols covering data accuracy, model integrity, algorithm reliability, and analytical consistency.
• Identify and mitigate risks related to data integrity, modeling quality, algorithmic bias, and responsible use of analytical outputs.
• Work with IT and business stakeholders to improve data capture and infrastructure for longitudinal, predictive, and advanced analytical use cases.
• Represent Care Management data needs across departments, clarify requirements, communicate findings, and support leadership with data-informed decisions.
• Ensure reports, dashboards, metrics, code, and analytical workflows are accurately documented and maintained.

Requirements:

• Bachelor’s degree in Data Science, Statistics, Computer Science, Mathematics, or another quantitative STEM discipline with a strong focus on computational modeling and statistical analysis.
• 6+ years of experience in advanced data analytics or data science, including at least 2 years focused on predictive modeling, machine learning, or complex statistical programming within healthcare or a large-scale operational environment.
• Demonstrated experience translating business problems into clear analytical requirements and problem statements.
• Experience identifying, retrieving, integrating, storing, cleansing, and preprocessing data from multiple sources.
• Strong experience conducting exploratory data analysis and communicating analytical findings through reports, dashboards, and presentations.
• Proven ability to review analytical outputs for accuracy, consistency, and business relevance.
• Experience managing competing priorities, coordinating cross-functional stakeholders, and communicating effectively with both technical and non-technical audiences.
• Demonstrated ability to supervise, coach, and support data analytics or reporting professionals.
• Knowledge of healthcare operations, Care Management workflows, health plan performance metrics, and state reporting requirements is preferred.
• Experience with healthcare reporting portfolios, data warehouse reporting tools, or health plan performance metrics is an advantage.
• Proficiency in statistical programming languages such as R or Python for advanced data manipulation and analysis.
• Experience applying analytical or machine learning algorithms to identify complex patterns in healthcare, Medicaid, or Care Management data.
• Familiarity with machine learning frameworks and libraries such as Scikit-learn, TensorFlow, or PyTorch.
• Advanced SQL capabilities, including complex querying and data engineering for large-scale datasets.
• Strong analytical, conceptual, organizational, problem-solving, facilitation, and presentation skills.
• Ability to translate operational, leadership, project, and regulatory requirements into analytical work plans.
• Proficiency with Microsoft Excel, Microsoft Office, Teams, SharePoint, data visualization tools, and reporting platforms.
• Ability to represent Care Management data needs in leadership and project meetings and coordinate follow-up actions.
• Valid driver’s license required.
• Candidates must reside in North Carolina and be able to travel to the Morrisville, NC home office for onsite meetings as needed.

Benefits:

• Full-time remote position for candidates residing in North Carolina.
• Opportunity to lead advanced analytics and data science initiatives within a healthcare environment.
• Strategic influence over predictive modeling, machine learning, data governance, and operational transformation.
• Leadership responsibility for developing and mentoring a team of data analysts.
• Cross-functional collaboration with Care Management, Clinical Operations, IT, Business Intelligence, Quality, and executive leadership.
• Opportunity to work with large-scale healthcare datasets, predictive models, and advanced analytical technologies.
• Compensation determined based on education, experience, external market data, and internal equity.
• Occasional travel to the Morrisville, North Carolina home office for team meetings.