Lead Director, Medicare Risk Adjustment Informatics

Hispanic Alliance for Career Enhancement; Utah; Hybrid; USD 100,000 - 232,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Equity award program

Job summary

CVS Health seeks a Lead Director of Informatics to guide Medicare Advantage and ACA risk adjustment analytics, predictive modeling, and intervention strategy. The role drives risk score accuracy, regulatory compliance, and data-informed opportunities, reporting to senior management and collaborating across analytics, informatics, and data science teams.

This senior position may sit anywhere in the US, with a comprehensive benefits package and opportunities to influence strategic decisions within

Qualifications

• 10+ years of healthcare analytics, informatics, risk adjustment, actuarial, finance, data science, or related disciplines.
• 2+ years of leadership experience (direct reports, team lead).
• Advanced proficiency in SQL, SAS, Python, BigQuery, or similar.
• Experience with predictive analytics, machine learning, or data science concepts.

Responsibilities

• Lead Medicare Advantage and ACA risk adjustment analytics and predictive modeling.
• Direct risk adjustment intervention activities and performance evaluation.
• Provide executive-level presentations and strategic recommendations.
• Partner with technology and data engineering teams to enhance data architecture and analytics capabilities.
• Ensure CMS regulations, data governance, and data integrity controls.

Skills

Healthcare analytics

Leadership

SQL

SAS

Python

BigQuery

Machine learning

Financial modeling

Education

Bachelor's degree

Master's degree preferred

Tools

SQL

SAS

Python

BigQuery

Job description

CVS Health seeks a Lead Director of Informatics to guide Medicare Advantage and ACA risk adjustment analytics, predictive modeling, and intervention strategy. The role drives risk score accuracy, regulatory compliance, and data-informed opportunities, reporting to senior management and collaborating across analytics, informatics, and data science teams.

This senior position may sit anywhere in the US, with a comprehensive benefits package and opportunities to influence strategic decisions within