Lead Director, Medicaid Risk Adjustment Analytics

Hispanic Alliance for Career Enhancement; Connecticut; Hybrid; USD 100,000 - 231,540; Full time

Benefits offered by this job

Medical, dental and vision coverage

Retirement savings options

Job summary

CVS Health is seeking a Lead Director of Revenue Integrity Informatics (Medicaid) to guide Medicaid risk adjustment analytics, reporting, and informatics. This senior role shapes strategy, ensures accuracy, and drives value across markets and plans.

Responsibilities include leading strategic initiatives, building scalable data pipelines, and aligning risk programs with state Medicaid models while collaborating with actuarial and finance teams to optimize revenue capture.

Qualifications

• 10+ years in healthcare analytics and risk adjustment with claims.
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Responsibilities

• Provide strategic leadership for Medicaid risk adjustment analytics.
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Skills

Healthcare analytics

Risk adjustment

Leadership

SAS

SQL

Python

BigQuery

Snowflake

Databricks

Regulatory expertise

Encounter data

Risk models

Data visualization

Stakeholder communication

Education

Bachelor's degree

Master's degree preferred

Tools

Tableau

Power BI

QuickSight

Looker

Job description

CVS Health is seeking a Lead Director of Revenue Integrity Informatics (Medicaid) to guide Medicaid risk adjustment analytics, reporting, and informatics. This senior role shapes strategy, ensures accuracy, and drives value across markets and plans.

Responsibilities include leading strategic initiatives, building scalable data pipelines, and aligning risk programs with state Medicaid models while collaborating with actuarial and finance teams to optimize revenue capture.