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GuideWell Mutual

Nonprofit mutual health insurance group in Florida

Vice President Health Services Analytics

Full-Time
No salary listed
Expert
Bachelor's, Master's
Jacksonville, FL, USA+1 moreMore locations: United States
In Person
Data & AnalyticsData Engineering, Business Intelligence

About the job

Requirements
  • A bachelor's degree in actuarial science, statistics, mathematics, data science, computer science, business, or a related quantitative field, or additional related work experience.
  • At least 15 years of progressive experience in healthcare analytics, actuarial science, data science, or enterprise analytics leadership.
  • At least 8 years of senior leadership experience overseeing analytical teams and enterprise-scale initiatives.
  • Demonstrated experience designing and implementing analytics operating models.
  • Ability to influence cross-functional senior leadership.
  • Demonstrated ability to translate analytical insights into measurable business outcomes.
  • Sedentary work involving exerting up to 10 pounds of force occasionally to move objects; traversing activities are required only occasionally.
Responsibilities
  • Position the analytics functions as the engine behind the data-driven Health Services Operating System, refocusing them on a Unified KPI and Operating Performance Dashboard, automation and AI-driven efficiencies, and business process improvement to improve member health outcomes and experience and reduce administrative and medical expenses.
  • Translate data, advanced analytics, and AI-powered insights into measurable business outcomes.
  • Partner with the Chief Data Officer to adopt the Analytics Domain architecture within Health Services Analytics and migrate analytical functions from legacy platforms to modern cloud-based solutions.
  • Define and own the North Star for Health Services Analytics, including its future-state vision, required capabilities, and proving metrics.
  • Lead phased implementation of the North Star vision, including required capabilities, proving metrics, value drivers, organizational design, process maps, technology and data architecture, governance, strategic roadmap, maturity assessment, and management system.
  • Align analytics strategy with Health Services Operations priorities and quantify business impact across STARS, RAF, quality, cost, and experience dimensions.
  • Establish and govern a unified analytics operating model with one intake process, prioritization framework, data product strategy, governance model, set of enterprise metrics, transformation layer, and AI enablement roadmap.
  • Implement an Analytics Product Roadmap by articulating demand, prioritizing work, managing capacity, justifying budget, tracking value realization, and partnering with Technology's Front Door to provide visibility into request volume, type, requestor, and status.
  • Represent analytics in operational engine governance forums, providing analytics input and ensuring data-informed decisions.
  • Operate a disciplined management system for the analytics engine, including weekly staff meetings, direct-report one-on-ones, skip-levels, quarterly roadmap revisions, and a structured operating rhythm.
  • Design, build, and maintain a comprehensive Health Services Operations KPI inventory with leading indicators, activity and outcome metrics, benchmarks, targets, red/yellow/green status reporting, and automated corrective-action triggers.
  • Deliver the Unified KPI and Operating Performance Dashboard as the single source of truth for Health Services Operations and roll it into the enterprise Operating Performance Dashboard.
  • Build and own the standardized, governed transformation layer between enterprise data products and Health Services analytics products, including metric definitions, transformation pipelines, business logic, enrichment layers, and quality checks, to eliminate duplicated pipelines, inconsistent outputs, and shadow data engineering.
  • Lead the migration of Health Services analytical functions from legacy platforms to modern cloud-based solutions in partnership with the Chief Data Officer, ensuring data is ready to be consumed at the point of use without secondary engineering.
  • Shift the analytics engine's work mix from recurring reporting and ad hoc requests toward advanced analytics, predictive models, AI-enabled workflows, and proactive intelligence, and track the shift as a maturity metric.
  • Develop and execute the AI enablement roadmap for Health Services Analytics, embedding predictive models and AI into the standardized transformation layer in alignment with enterprise standards.
  • Identify and implement automation and AI-driven efficiencies within analytics, including automated reporting, self-service dashboards, and decision-support tools.
  • Lead development of predictive models and AI/ML use cases identified in each operational engine's tactics table, aligned with the enterprise AI roadmap.
  • Own analytics capability for TCOC connectivity across engines by defining how analytics identifies affordability opportunities, recurring reviews, prioritization, calendarization, and impact tracking and validation.
  • Maintain the connection between engine-level analytics and Medical Economics/Affordability, ensuring TCOC opportunities are quantified, tracked, and validated through recurring sustainable processes.
  • Support subfunction lever playbooks by identifying the KPIs each lever moves, the TCOC cost category and cost mechanism affected, and the required analytics cadence.
  • Build, lead, and develop the Health Services Analytics team, including analysts, analytics engineers, data scientists, and reporting specialists.
  • Define the analytics engine staffing model, including filled and vacant FTEs, workforce mix, onshore/offshore/vendor split, and productivity expectations.
  • Upskill, restructure, and rebuild the analytics talent pyramid toward analytics engineers, data scientists, and AI-enabled roles, and track the shift as a maturity metric.
  • Establish leadership development plans, talent assessments, and performance management systems for the analytics organization.
Desired Qualifications
  • Fellow of the Society of Actuaries (F.S.A.) or an equivalent advanced credential.
  • An advanced degree (master's or higher) in a quantitative or business discipline.
  • Experience within a health insurance payer organization.
  • Experience partnering with enterprise data organizations.
  • Experience with process improvement methodologies such as LEAN or Six Sigma.
  • Experience developing recruiting strategies, talent programs, and team members.
  • Experience implementing AI-enabled analytics solutions into business workflows.

About the company

GuideWell Mutual Holding Corporation is the not-for-profit, policyholder-owned parent of Florida Blue, the Blue Cross and Blue Shield health insurer for Florida. Its family of companies also includes Triple-S, which runs the Blue plans in Puerto Rico, and GuideWell Source, which processes Medicare claims for the federal government through Novitas Solutions and First Coast Service Options. Most income comes from health plan premiums paid by employers, individuals and Medicare members, plus fees for running claims for others. As a mutual, it has no shareholders, and Florida Blue policyholders control it. GuideWell was formed in 2013 and is based in Jacksonville, Florida.

Company Size

10,001+

Company Stage

N/A

Total Funding

N/A

Headquarters

Jacksonville, Florida

Founded

2011

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Simplify Jobs

Simplify's Take

What believers are saying

  • Brian Pieninck became CEO October 1, 2025, bringing CareFirst operating discipline.
  • AM Best affirmed GuideWell's long-term issuer rating at a- on July 30, 2026.
  • GuideWell earned Great Place to Work certification in 2026, aiding recruiting.

What critics are saying

  • GuideWell cut workforce 3% in January 2025, signaling continued margin pressure.
  • Broward Health sued Florida Blue in April 2026 over emergency-room underpayments exceeding $750,000.
  • Florida Blue's MIHC filing risks regulatory delay and policyholder revolt after approval.

What makes GuideWell Mutual unique

  • GuideWell remains a policyholder-owned, not-for-profit health solutions platform across 50 states.
  • Florida Blue gives GuideWell a dominant Florida payer base and integrated delivery footprint.
  • GuideWell Innovation Center, launched in Jacksonville, anchors payer-provider experimentation and partner access.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • 401(k) Retirement Plan
  • 401(k) Company Match
  • Paid Vacation
  • Unlimited Paid Time Off
  • Wellness Program

Company News

DistilInfo
Aug 20th, 2026
Health Net taps CEO from Nevada plan.

Health Net taps CEO from Nevada plan. Table of contents. Centene's Health Net named Eric Schmacker as plan president and CEO, confirming the Eric Schmacker Health Net CEO appointment following his tenure as the health plan's interim leader. How the Eric Schmacker Health Net CEO appointment came together. Schmacker most recently held the same role at Silver Summit Health Plan, another Centene plan in Nevada, a LinkedIn announcement said. Leading up to his official appointment, he has been Health Net's interim plan president. This progression from interim leadership to permanent appointment suggests Centene opted for continuity, promoting a leader already familiar with Health Net's operations rather than conducting an external search from scratch. Why his Nevada background matters. Having previously led another Centene-owned plan in Nevada gives Schmacker direct experience navigating the same corporate structure and operational expectations he'll now apply at Health Net, a factor that may have streamlined his transition into the permanent role. Schmacker's background before this Health Net CEO appointment. Before Centene, Schmacker held executive roles at Tenet Healthcare's San Antonio, Texas-based Baptist Health System, including CEO of St. Luke's Baptist Hospital, CEO of Mission Trail Baptist Hospital, and COO of North Central Baptist Hospital. He is also a 21-year U.S. Army veteran. Why this combination of experience stands out. Schmacker's background spanning multiple hospital COO roles within a major health system, combined with more than two decades of military service, gives him a leadership profile shaped by both large-scale healthcare operations and the discipline associated with a long military career, a combination that may prove valuable as he takes on the operational demands of leading a Medicaid-focused managed care plan. Why this Health Net CEO transition matters. Former Health Net CEO Brian Ternan left the company in July to serve as GuideWell's executive vice president of commercial business. This departure created the leadership vacancy Schmacker has now filled, following a relatively swift transition from Ternan's exit to Schmacker's confirmed permanent appointment. How this fits a broader wave of payer executive turnover. This appointment adds to a broader pattern of health plan C-suite transitions in 2026, with Becker's separately tracking 22 health plan C-suite exits this year alone, spanning regional plans and large, for-profit insurers alike. The same week also brought news of Cambia Health Solutions naming a new CEO for its third-party administrator subsidiary and a CVS Health board appointment. What this Eric Schmacker Health Net CEO appointment means going forward. With Schmacker's transition from interim to permanent CEO now complete, Health Net has resolved its leadership uncertainty following Ternan's July departure, giving the plan stable, confirmed leadership as it continues operating within Centene's broader managed care portfolio. Given Schmacker's prior experience leading another Centene plan in Nevada, his approach to Health Net's operations may reflect lessons and strategies carried over directly from his time at Silver Summit Health Plan. What to watch going forward. As Schmacker settles into his permanent role, industry observers will likely watch how his hospital operations background and military leadership experience shape Health Net's strategic priorities going forward. Given the broader wave of health plan executive turnover occurring across the industry in 2026, this Eric Schmacker Health Net CEO appointment may offer one more data point in understanding how insurers are approaching leadership transitions amid a year marked by significant C-suite change across the payer sector.

Port Arthur News
Aug 4th, 2025
GuideWell appoints Brian D. Pieninck president & CEO

JACKSONVILLE, Fla., Aug. 4, 2025 /PRNewswire/ - GuideWell Mutual Holding Corporation has appointed Brian D. Pieninck as its next president and chief executive officer (CEO), effective Oct. 1.

PR Newswire
May 2nd, 2025
Florida Blue Foundation Honors Nine Nonprofits From Across The State For Innovation And Community Impact During 20Th Annual Sapphire Awards

ORLANDO, Fla., May 2, 2025 /PRNewswire/ -- The Florida Blue Foundation, the philanthropic affiliate of Florida Blue, is proud to announce the nine finalists for the 2025 Sapphire Awards, recognizing outstanding programs, organizations, and individuals making a significant impact in community health across Florida.2025 Sapphire Award WinnersAt its annual Community Health Symposium and Sapphire Awards on May 1 in Orlando, the Florida Blue Foundation announced the winners who will share $525,000 to continue their local impact work. This year's symposium theme highlighted the power of technology, innovation, and AI in improving health outcomes for many in the state."We are thrilled to celebrate the 20th anniversary of the Sapphire Awards and recognize the outstanding contributions of these programs, organizations and individuals," said Florida Blue Foundation Executive Director, Susan Towler. "Each of the honorees is dedicated to innovation that improves the lives of Floridians, and we are honored to support their inspiring work."Below are the programs that were honored:The Family Navigator program, led by Alzheimer's Community Care ( West Palm Beach , Palm Beach County ) provides a lifeline of support, tools, and resources to family caregivers, empowering them to care for their loved ones at home. The program has served 3, 846 patients and caregivers and has achieved an 85% success rate. The Family Navigator program received a first-place award and $100,000. Watch their video., ) provides a lifeline of support, tools, and resources to family caregivers, empowering them to care for their loved ones at home

PR Newswire
Mar 31st, 2025
Guidewell / Florida Blue Ceo Pat Geraghty To Step Down At Year End

Tenure Marked by Dramatic Growth, Industry Leadership, and Statewide Community ImpactJACKSONVILLE, Fla., March 31, 2025 /PRNewswire/ -- Pat Geraghty will retire from his role as president and chief executive officer of GuideWell and Florida Blue on December 31, 2025, after serving since 2011, the company announced today. During his tenure, Geraghty, 65, led the transformation of Florida's largest health insurer into GuideWell, a comprehensive health solutions enterprise, with a significant presence in Puerto Rico and across the country while also expanding Florida Blue's reach and impact across the state.GuideWell & Florida Blue President & CEO, Pat GeraghtyThomas G. Kuntz, Chairman of the GuideWell and Florida Blue Boards of Directors, stated, "Pat Geraghty's visionary leadership has transformed our organization and positioned us as a national leader in the evolution of health care. His commitment to members, employees, and the communities GuideWell serves has been extraordinary. Under his guidance, the company has grown from $8 billion to $32 billion in revenue while maintaining a strong mission focus. He has strengthened the company immeasurably and his dedication to our values and to helping people and communities achieve better health has had a profound impact on our culture, the health insurance industry, and the communities where GuideWell and its companies operate.""Being entrusted with the leadership of GuideWell / Florida Blue has been the highlight of my career," said Geraghty

South Florida Hospital News
Mar 12th, 2025
GuideWell and Florida Blue Appoint Julia M. Brown to Board of Directors

GuideWell and Florida Blue appoint Julia M. Brown to board of directors.