Principal Risk Adjustment & Revenue Integrity Analytics Lead

For our client, we are seeking a Principal Risk Adjustment & Revenue Integrity Analytics Lead to join the team of a leader in the Healthcare space. This leader will drive the analytics that support Medicare Advantage risk adjustment and revenue integrity across the payment lifecycle. The role will focus on forecasting, variance analysis, and reconciliation to improve the accuracy of risk-score performance and executive decision-making. You will partner closely with internal stakeholders to identify high-impact opportunities, strengthen reporting, and translate complex data into clear business insights. Location: Remote - US based candidates only, no visa sponsorship available Compensation: $133,200 – $180,900 annually Responsibilities Design, build, and maintain analytics for Part C and Part D risk-score performance Develop risk-score and revenue forecasting models with variance analysis Trace diagnoses and HCCs throughout the payment lifecycle for reconciliation Analyze opportunities for recapture and chart reviews to demonstrate ROI Collaborate with internal teams to prioritize high-impact risk adjustment initiatives Automate reporting processes and create scalable dashboards to improve efficiency Ensure accuracy and trustworthiness of business logic and data for executive reports Translate complex analytics into clear narratives for leadership decision-making Qualifications Bachelor's degree in Mathematics, Statistics, Computer Science, Data Analytics, Health Informatics, Finance, or Actuarial Science 8+ years of healthcare analytics experience in Medicare Advantage Part C risk adjustment, RAF, and CMS-HCC Experience analyzing Part C risk-score performance and identifying drivers such as coding trends and population mix Proficient in risk adjustment data flows including claims/encounters and eligibility data Ability to build and reconcile forecast-to-actual performance across various financial metrics Hands-on experience in SQL to extract and reconcile data from large databases Familiarity with dashboards and automated reporting tools like Power BI or Tableau Benefits Medical, Vision and Dental Plans Tax-Advantage Savings Accounts (FSA & HSA) Life Insurance and Disability Insurance Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) Employee Assistance Program 401k with company match Learning and Development Opportunities Employee Resource Groups Employee Discount Program Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.