Manager of Risk Adjustment Analytics
About The Position
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. The Manager of Risk Adjustment Analytics strengthens VillageCare Max's ability to monitor and improve performance in shared savings arrangements across Medicare Advantage, Medicaid, commercial, and traditional Medicare. This role exists to translate complex risk adjustment and value-based care data into clear insights that guide forecasting, operational decisions, and improvement priorities. Key responsibilities include leading risk adjustment analytics with an initial emphasis on Medicare Advantage and Medicare; tracking risk-score movement and flagging anomalies; applying expert knowledge of CMS/HCC methodology and claims-based data; building dashboards and concise reporting for internal and external stakeholders; and collaborating with Performance, Finance, and data engineering teams to ensure data is reliable and analysis-ready.
Requirements
- 6-10 years in risk adjustment and/or healthcare analytics
- Deep expertise in Medicare Advantage risk adjustment, HCC modeling, and CMS methodologies
- Strong knowledge of value-based care contracts, policy, operations, and financial methods
- Proficiency with SAS, SQL, and data mining tools
- Bachelor's degree required
Nice To Haves
- Master's preferred
Responsibilities
- Lead risk adjustment analytics with an initial emphasis on Medicare Advantage and Medicare
- Track risk-score movement and flag anomalies
- Apply expert knowledge of CMS/HCC methodology and claims-based data
- Build dashboards and concise reporting for internal and external stakeholders
- Collaborate with Performance, Finance, and data engineering teams to ensure data is reliable and analysis-ready
- Translate complex risk adjustment and value-based care data into clear insights that guide forecasting, operational decisions, and improvement priorities
- Review updated risk score outputs and trend views
- Align with Performance and Finance partners on what leaders need explained or forecasted for upcoming contract discussions
- Refine visualizations so insights are easy to interpret
- Work with data ingestion and engineering to validate claims availability and resolve data questions before conclusions are shared
- Synthesize findings into a clear narrative-what changed, why it matters, and what actions are implied
- Prepare materials for stakeholder readouts
- Balance detail-oriented validation with timely delivery, supporting VillageCare Max's learning and improvement across shared savings programs
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What This Job Offers
Job Type
Full-time
Career Level
Manager
