Senior Informatics Manager, Risk Adjustment Analytics Remote

CVS Health

3d•$67,900 - $199,144•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary CVS Health has an exciting opportunity for a Senior Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will lead and execute complex data analyses to drive health plan-level risk adjustment performance through data-driven insights and analytical leadership. This position manages a small team (1-2 employees) responsible for designing and delivering advanced analytics, interpreting large healthcare datasets, and translating findings into actionable strategies that improve quality outcomes and financial performance. The role partners across finance, actuary, and analytics teams to support health plan and enterprise initiatives while ensuring alignment with state Medicaid and CMS regulatory requirements.

Requirements

8+ years of relevant professional experience in healthcare analytics, including working with claims and encounter data
2+ years of leadership experience managing, coaching, or mentoring team members
Experience with government-regulated healthcare programs (Medicaid, Medicare, and/or ACA)
Advanced technical skills in Google Cloud Platform (GCP)/Big Query, SQL, SAS, Python, or similar programming languages
Demonstrated experience working with large, complex healthcare datasets and performing root cause analysis
Proven ability to manage multiple projects and competing priorities in a fast-paced environment
Strong ability to translate technical analyses into actionable business insights
Excellent communication skills across technical and non-technical audiences

Nice To Haves

Experience with risk adjustment methodologies and performance analytics
Knowledge of CMS and state Medicaid data, reporting, and compliance requirements
Experience with data visualization tools (e.g., Tableau, Power BI)

Responsibilities

Evaluate health plan performance using advanced analytics to identify trends, gaps, and opportunities across Medicaid populations
Design and execute complex analyses leveraging medical and pharmacy claims, encounter, provider, and membership data
Translate analytical findings into clear, actionable insights to drive health plan strategies and decision-making
Develop and maintain scalable reporting, dashboards, and performance monitoring tools
Support development of data models, forecasting approaches, and performance measurement frameworks
Ensure data accuracy, integrity, and governance across reporting and analytical outputs
Identify and implement process improvements through automation and advanced analytics
Communicate complex findings effectively to both technical and non-technical stakeholders
Support compliance with CMS and state Medicaid requirements through accurate, timely reporting and analysis