Sr. Manager Health Business Analytics, Medicare Risk Adjustment
New
United StatesFull-TimeManager
Salary119,400 - 194,000 USD per year
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Job Details
- Experience
- 8+ years related work experience; 3+ years direct supervisory/management experience
- Required Skills
- SQLMicrosoft Excel
Requirements
- 8+ years of related work experience.
- 3+ years of direct supervisory or management experience.
- Strong Risk Adjustment experience in commercial or Medicare environments.
- Bachelor’s degree in a related field or equivalent work experience.
- Experience working with statistical methodologies and risk adjustment.
- Proficiency writing SQL or SAS code to perform quantitative risk score analysis.
- Advanced Excel skills.
- Experience using algorithms and inferential statistics.
- Expert consulting, negotiating, communicating, consensus building, presentation, and facilitation skills.
- In-depth business process knowledge of key business functional areas.
- Ability to understand overall analytics strategy and apply it to initiatives.
- Experience communicating and presenting detailed business and financial information.
Responsibilities
- Oversee the end-to-end strategy for risk adjustment programs, including prospective and retrospective processes.
- Manage provider workflows, chart reviews, and coding validation to ensure accurate documentation under CMS-HCC models.
- Partner with actuarial and finance teams to support bid development, producing defensible risk score projections, trend analysis, and revenue assumptions.
- Communicate complex analytic results and financial information to executive leadership.
- Plan, forecast, and set objectives while establishing goals and accountabilities for the team.
- Lead predictive analytic modeling to drive business decisions and regulatory compliance.
- Manage performance, coach and develop employees, and foster professional growth within the organization.
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