Healthcare Risk Adjustment Analytics Lead

CVS Health; Hartford (CT); On-site; USD 66,000 - 146,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Job summary

CVS Health is seeking a senior analytics leader for the Medicare Risk Adjustment team. You will drive end-to-end risk adjustment processes, ensure data quality and regulatory reporting, and lead cross-functional data initiatives across encounters, CMS rules, and analytics.

We value deep regulatory knowledge, strong project leadership, and experience shaping data governance in healthcare. This full-time role offers a competitive benefits package and bonus eligibility.

Qualifications

• 7+ years of healthcare analytics experience.
• 5+ years of Medicare Risk Adjustment, EDS, MAO-004, or ACA analytics experience.
• Experience leading projects and healthcare data initiatives.
• Strong knowledge of CMS regulations, HCC models, and regulatory reporting.

Responsibilities

• Lead cross-functional projects in large-scale healthcare data operations, compliance, data quality and analytics initiatives.
• Own end-to-end Risk Adjustment processes, encounter data validation, HCC analytics, CMS reporting and data governance.
• Drive regulatory compliance and data-driven decision making across the team.

Skills

Healthcare analytics

Regulatory knowledge

Project leadership

Data governance

Education

Bachelor’s degree

Rel. work exp.

Tools

SQL

SAS

Databricks

Cloud platforms

Power BI

Job description

CVS Health is seeking a senior analytics leader for the Medicare Risk Adjustment team. You will drive end-to-end risk adjustment processes, ensure data quality and regulatory reporting, and lead cross-functional data initiatives across encounters, CMS rules, and analytics.

We value deep regulatory knowledge, strong project leadership, and experience shaping data governance in healthcare. This full-time role offers a competitive benefits package and bonus eligibility.