Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Ladders · United States · 1 wk ago
RemoteRemoteHealthcare$100k–$232k/yrFull-time
Responsibilities
- Define and execute Medicaid risk adjustment strategy across various markets
- Lead high-impact initiatives to improve revenue accuracy and compliance
- Oversee health plan performance analytics and evidence-based decision making
- Establish and manage processes for risk score accuracy and integrity
- Direct development of analytics frameworks for predictive modeling and reporting
- Evaluate risk adjustment programs through performance measurement and program KPIs
- Lead a multidisciplinary team to optimize operations and analytics workflows
Qualifications
- 10+ years of healthcare analytics experience, specifically in risk adjustment and claims knowledge
- 3+ years of leadership experience with team management
- Advanced technical skills in SAS, SQL, Python, or cloud platforms like BigQuery or Databricks
- Expertise in risk adjustment methodologies and encounter data processes
- Strong familiarity with risk models and state reconciliation procedures
- Prominent track record in strategic initiative execution with measurable outcomes
Benefits
- Comprehensive medical, dental, and vision coverage
- Paid time off for personal and family needs
- Retail savings options to plan for the future
- Wellness programs focusing on physical and emotional health
- Resources and support for overall employee well-being