Manager of Risk Adjustment Analytics
About The Position
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. A typical workday is structured around focused analysis time and cross-functional touchpoints. You may start by reviewing updated risk score outputs and trend views, then align with Performance and Finance partners on what leaders need explained or forecasted for upcoming contract discussions. Midday often includes refining visualizations so insights are easy to interpret, followed by working sessions with data ingestion and engineering to validate claims availability and resolve data questions before conclusions are shared. As the day progresses, you synthesize findings into a clear narrative-what changed, why it matters, and what actions are implied-then prepare materials for stakeholder readouts. In this fast-paced environment, you balance detail-oriented validation with timely delivery, supporting VillageCare Max's learning and improvement across shared savings programs.
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 degree 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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
