Senior Manager Medicare Risk Adjustment

Job Summary

Managing a team remotely, the full-time Senior Manager Medicare Risk Adjustment will oversee strategy implementation and execution for Medicare Risk Adjustment Programs, focusing on optimizing risk adjustment processes and enhancing revenue accuracy through data-driven decisions.

Key responsibilities

• Oversee end-to-end strategy for risk adjustment programs, managing provider workflows and ensuring accurate documentation
• Partner with actuarial and finance teams to support bid development and produce risk score projections and trend analysis
• Lead analysis and recommendations while managing employee performance and professional growth within the team

Required qualifications

• 8+ years of related work experience, particularly in risk adjustment for commercial and Medicare
• 3+ years of direct supervisory or management experience
• Bachelor's degree or equivalent related work experience
• Experience with statistical methodologies and risk adjustment, including SQL/SAS coding for quantitative analysis
• Advanced Excel skills and the ability to communicate complex information effectively