Senior Manager, Healthcare Medicaid Risk Adjustment Analytics

This is a fully remote position, open to applicants in Idaho, +2 more states.

📋 Description

• Assess health plan performance through advanced analytics to uncover trends, gaps, and opportunities within Medicaid populations.

• Craft and implement intricate analyses utilizing medical and pharmacy claims, encounter, provider, and membership data.

• Convert analytical results into clear, actionable insights to enhance health plan strategies and facilitate decision-making.

• Create and sustain scalable reporting systems, dashboards, and performance monitoring tools.

• Assist in the development of data models, forecasting techniques, and performance measurement frameworks.

• Ensure the accuracy, integrity, and governance of data throughout reporting and analytical outputs.

• Identify and enact process enhancements through automation and advanced analytics.

• Effectively communicate complex findings to both technical and non-technical stakeholders.

• Aid in ensuring compliance with CMS and state Medicaid requirements through precise and timely reporting and analysis.

⛳️ Requirements

• Over 8 years of relevant professional experience in healthcare analytics, specifically with claims and encounter data.

• At least 2 years of leadership experience in managing, coaching, or mentoring team members.

• Familiarity with government-regulated healthcare programs (Medicaid, Medicare, and/or ACA).

• Advanced technical proficiency in Google Cloud Platform (GCP)/Big Query, SQL, SAS, Python, or similar programming languages.

• Proven experience working with large, complex healthcare datasets and conducting root cause analysis.

• Demonstrated ability to juggle multiple projects and competing priorities in a dynamic environment.

• Strong capability to translate technical analyses into actionable business insights.

• Excellent communication skills tailored for both technical and non-technical audiences.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources.