Risk Adjustment Financial Analytics Lead

Humana

3d • Remote

About The Position

Become a part of our caring community The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Location: remote however if local must be available to work in the office on Wednesdays This role will lead the revenue and risk score forecasting of Humana’s End Stage Renal Disease (ESRD) population across bids, budget, and forecast cycles. Drive monthly current‑year forecasting, analyze membership and ESRD cohort mix changes, assess CMS model and policy impacts, and deliver early insights to leadership. In addition, this role will work closely with team members to solve complex problems through collaboration and supports business partners across the enterprise including Actuarial, Finance, and Operations.

Requirements

• Bachelors degree in business, finance, analytics, or any field
• 6+ years finance, analytics, and/or healthcare or 7+ years total work experience
• Proven experience developing and maintaining financial or analytical models
• Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends
• Explains variances and trends and enhances modeling techniques
• SQL, SAS or other programing language

Nice To Haves

• Project or associate development leadership experience
• Experience in Medicare Advantage Risk Adjustment or ESRD forecasting

Responsibilities

• Lead end‑to-end premium projections supporting Bids, Budget, and Quarterly Financial Forecast cycles.
• Own monthly current‑year forecast processes, incorporating emerging experience and membership changes.
• Monitor ESRD membership and mix changes, assessing downstream impacts on revenue and forecast accuracy.
• Deliver early performance indicators to leadership highlighting emerging risks and opportunities.
• Conduct actual‑versus‑expected analyses to identify variances, root causes, and opportunities for ongoing forecast and model improvements.
• Maintain, enhance, and validate internal ESRD risk score engine models for risk adjustment valuations.
• Analyze CMS ESRD risk model and policy changes, quantify financial impact, and communicate implications for bids, forecasts, and long-term strategy.
• Support the Individual Medicare Advantage (MA) team in bid development reviewing bid assumptions and validating plan‑level MA risk score projections.

Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
• Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
• Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees