Manager, Medicare Risk Adjustment Analytics Consulting - REMOTE
About The Position
The Medicare Risk Adjustment Analytics Consulting Manager is a Subject Matter Expert (SME) who will drive revenue integrity and analytics strategy by serving as the primary consultative resource for strategic initiatives. This role leads cross-functional, matrixed teams and works directly with risk adjustment analysts to transform complex financial and risk adjustment data into actionable business intelligence. Additionally, the SME champions advanced data science initiatives by supporting the end-to-end development, refinement, and deployment of predictive models. As a key advisor to the business, the SME consistently delivers strategic, data-driven insights and collaborates with key stakeholders to ensure revenue accuracy and analytic product integrity. Core responsibilities include consultive leadership, translating complex risk adjustment analyses into high-impact strategic recommendations and presentations. The manager is a strategic advisor, collaborates with key business partners and oversees the design and execution of complex data initiatives.
Requirements
- Bachelor Degree in Math, Actuarial Science, Business Statistics, Accounting or Finance OR 4 years experience.
- 5 years experience interfacing with external clients, large employers, brokers, or consultants OR 5 years experience in presenting analytic results to both internal and external audiences.
- 5 years experience in requiring data analysis and information reporting related to healthcare data.
- 2 years leadership experience.
- Negotiation, decision-making, organizational, and analytical skills.
- Verbal and written communication skills, including presentation skills.
- PC proficiency to include Access, Excel, Word, and PowerPoint.
Nice To Haves
- Deep Medicare Risk Adjustment experience (HCC models, risk score calculations, RADV audits).
- Proven success leading data projects and influencing indirect reports, peers, and cross-functional teams in a complex environment and without formal authority.
- Advanced understanding of querying, manipulating, and visualizing healthcare data (e.g.' SQL, SAS, Python, Tableau or Power BI).
- Exceptional presentation skills reporting to C-suite or executive-level stakeholders including the ability to simplify complex data analyses into business insights for non-technical partners.
Responsibilities
- Drive revenue integrity and analytics strategy by serving as the primary consultative resource for strategic initiatives.
- Lead cross-functional, matrixed teams and work directly with risk adjustment analysts to transform complex financial and risk adjustment data into actionable business intelligence.
- Champion advanced data science initiatives by supporting the end-to-end development, refinement, and deployment of predictive models.
- Deliver strategic, data-driven insights and collaborate with key stakeholders to ensure revenue accuracy and analytic product integrity.
- Provide consultive leadership, translating complex risk adjustment analyses into high-impact strategic recommendations and presentations.
- Act as a strategic advisor, collaborate with key business partners and oversee the design and execution of complex data initiatives.
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Annual incentive bonus plan
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What This Job Offers
Job Type
Full-time
Career Level
Manager
