Director, Managed Care Analytics

POSITION SUMMARY/RESPONSIBILITIES

The Director, Managed Care Analytics serves as the enterprise leader for payer analytics, contract modeling, and contract performance optimization. This role is responsible for developing advanced financial, statistical, and predictive models to support managed care contracting strategy, value-based care performance, and revenue optimization. The Director transforms traditional analytics into a modern, AI-augmented decision capability  leveraging automation, machine learning, and advanced data platforms to deliver predictive, prescriptive, and real-time insights across the payer lifecycle. This position collaborates cross-functionally with Patient Business Services, Revenue Integrity, Patient Access, Finance, clinical operations, and IT to ensure data integrity, actionable insights, and strategic alignment, and serves as a trusted advisor to the Vice President, Payer Relations. The Director also contributes to AI governance and the responsible use of data, ensuring transparency, compliance, and appropriate human oversight in analytic and decision-support processes.

EDUCATION/EXPERIENCE

Education

• Required: Bachelor's Degree in Finance, Healthcare Administration, Data Analytics, Statistics, or a related field.
• Preferred: Master's degree (MBA, MHA, Health Informatics, Data Science, or equivalent). Graduate-level preparation is strongly preferred for this enterprise analytics leadership role.

Experience

• 8 or more years of progressive experience in healthcare analytics, decision support, or revenue cycle analytics.
• 3 to 5 or more years in a leadership or management role.
• Demonstrated experience leading payer contract modeling and supporting negotiation strategy.
• Experience with value-based care and alternative payment models.
• Experience building or modernizing analytics capabilities preferred.

Technical and Functional Expertise

• Advanced proficiency in Excel and data modeling.
• Advanced proficiency in BI tools such as Tableau.
• Experience with healthcare data including claims, clinical records, and EHR data.
• Experience with contract modeling tools and systems.
• Working knowledge of AI applications in healthcare analytics.
• Working knowledge of predictive modeling.

Domain Knowledge

• Strong working knowledge of Medicare Advantage, Medicaid (including Texas programs), and commercial exchange products.
• Strong knowledge of reimbursement methodologies and contract structures.
• Familiarity with data integration challenges in healthcare.

LICENSURE

• HFMA certification preferred.
• Epic Resolute expected reimbursement certification required.