Senior Consultant - Risk Adjustment (ACA)

Wakely Consulting Group•,

About The Position

Wakely, an HMA company, is seeking a Senior Consultant with specialized experience in Affordable Care Act (ACA) risk adjustment analytics. The role leads client engagements, coordinates multidisciplinary teams, develops actionable recommendations, and supports the growth of Wakely’s risk adjustment offerings. The Senior Consultant manages client relationships and project teams to achieve strategic goals and deliver high-quality work on time, and has supervisory responsibilities. The position includes leading ACA risk adjustment analyses, including risk accrual development and EDGE data evaluation; advising health plan executives on financial and operational impacts; and monitoring market and regulatory developments. The Senior Consultant communicates findings and recommendations to client leadership, applies Wakely tools and methodologies, supports business development, and collaborates with actuarial, coding, operations, and data analytics teams. The role also encompasses broader client, project, professional development, business development, and internal operations responsibilities, including maintaining client relationships, managing project plans and deliverables, mentoring staff, contributing to training and resources, pursuing new business opportunities, supporting operational efficiency, and participating in recruitment and community or professional volunteer opportunities.

Requirements

Demonstrated experience leading ACA risk adjustment analytics within a health plan or leading strategic risk adjustment consulting engagements.
Deep understanding of the ACA risk adjustment program and its impact on health plan rate filings and financial performance.
Strong knowledge of the full risk adjustment lifecycle, including coding, submissions, analytics, provider engagement, and regulatory requirements.
At least 8 years of experience in one or more of Wakely’s core areas: Medicaid, healthcare reform, ACA, Provider Sponsored Organizations, or Medicare Advantage.
At least 2 years of project management and client management experience.
Proven ability to manage projects, workflows, timelines, and deliverables across multiple engagements.
Ability to build trusted client relationships and clearly communicate complex technical, analytical, and operational concepts to senior leadership.
Excellent written and verbal communication skills and experience working across cross-functional and multidisciplinary teams.
Demonstrated leadership, initiative, accountability, and sound judgment in client and team interactions.
Commitment to mentoring team members and contributing to a collaborative learning environment.
Ability to make independent decisions, manage time and resources, continue learning, and think strategically.

Nice To Haves

A bachelor’s degree; significant directly relevant work experience may be considered in place of a formal degree.

Responsibilities

Serve as a primary client contact and coordinate with actuarial, coding, data, and operational experts to deliver integrated solutions.
Manage client relationships, understand client needs, and develop strategic plans to address them.
Develop and manage project plans, timelines, workflows, and deliverables across multiple engagements.
Lead and supervise project teams, delegate work, mentor junior staff, and ensure quality and timely deliverables.
Conduct periodic reviews of project plans, final deliverables, and post-project results.
Oversee project communications, facilitate constructive feedback, and ensure client updates and billing are completed within timelines.
Lead ACA risk adjustment analyses, including accrual development and EDGE data evaluation, and assess financial and operational impacts.
Provide strategic support to health plan executives and translate market or regulatory developments into practical client recommendations.
Draft actionable client deliverables and present findings, recommendations, and risk adjustment concepts to client leadership.
Apply Wakely products, tools, services, and methodologies to meet client needs and support internal initiatives.
Contribute to requests for proposals, proposal development, strategic scoping, service innovation, and growth of risk adjustment offerings.
Support business development through seminars, events, research papers, marketing initiatives, new business or product lines, and value-added services for current clients.
Implement industry training, identify employee development needs, and manage the creation of resources and reference materials.
Prioritize operational efficiency initiatives and support compliance with policies and procedures across offices.
Recruit talent and participate in selection and orientation processes.
Oversee and participate in community and professional volunteer activities or opportunities.
Perform other duties as assigned.