Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Hartford-Farmington Ave Rogers, United States
USD 100K-231K Senior-level Full Time
Tasks
- Define and execute Medicaid risk adjustment strategy
- Define program KPIs and measure intervention performance
- Develop data pipelines and reporting frameworks
- Direct suspecting logic and gap prioritization
- Drive automation and standardize tools and processes
- Ensure state audit readiness with data validation
- Establish governance and execution frameworks
- Lead risk adjustment analytics and reporting
- Monitor encounter data accuracy and completeness
- Oversee risk adjustment lifecycle reconciliation
- Perform predictive modeling and forecasting
- Provide people leadership and coaching
- Reconcile plan risk scores to state scores
- Validate risk score impacts on payments
Perks/Benefits
- Dental coverage
- Medical coverage
- Paid time off
- Retirement savings options
- Vision coverage
- Wellness programs
Skills/Tech-stack
AI | Amazon QuickSight | BigQuery | Cause analysis | Claims data | Clinical data | Data Engineering | Data Validation | Data Visualization | Databricks | Encounter Data | Forecasting | Looker | Machine Learning | Pharmacy data | Power BI | Predictive Analytics | Process Automation | Python | Risk adjustment | Root Cause Analysis | Root cause | SAS | SQL | Snowflake | Tableau | Variance analysis
Education
Bachelor of Engineering | Bachelor of Science | Master of Business Administration | Master of Science
Roles
Analytics Director | Data Analytics | Data Analytics Director | Director | Lead | Lead Director
Regions
Countries
States
Cities
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