Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Hartford-Farmington Ave Rogers, United States
USD 100K-231K Executive-level Full Time
Tasks
- Build predictive modeling and forecasting analytics
- Define Medicaid risk adjustment strategy
- Develop data pipelines and reporting frameworks
- Develop suspecting logic for gap identification
- Establish governance and prioritization frameworks
- Implement process automation for faster insights
- Lead cross-functional stakeholder alignment
- Lead reconciliation of risk scores revenue projections and state payments
- Lead risk adjustment analytics and reporting
- Manage team talent development and mentorship
- Monitor program KPIs for intervention effectiveness
- Oversee risk adjustment lifecycle data management
- Perform variance analysis and root cause identification
- Prepare for state audits with data validation documentation
- Reconcile plan risk scores to state scores
- Standardize tools reporting and processes across markets
- Validate encounter data for downstream impact
Perks/Benefits
Skills/Tech-stack
AI | Analytics | BigQuery | Cause analysis | Claims | Clinical data | Data Pipelines | Data Science | Data Validation | Data Visualization | Databricks | Encounter Data | Forecasting | Looker | Machine Learning | Medicaid | Pharmacy data | Power BI | Predictive Modeling | Process Automation | Python | QuickSight | Reporting | Risk adjustment | Risk scores | Root Cause Analysis | Root cause | SAS | SQL | Snowflake | Tableau | Trend analysis | Variance analysis
Education
Bachelor of Engineering | Bachelor of Science | Master of Science
Roles
Regions
Countries
States
Cities
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