Manager of Risk Adjustment Analytics

Village Center for Care, Inc.; New York (NY); Hybrid; USD 135,000 - 152,000; Full time

Job summary

VillageCare Max seeks a Manager of Risk Adjustment Analytics to strengthen performance across Medicare Advantage, Medicaid and commercial programs. You translate complex risk data into actionable insights and build dashboards for stakeholders.

The role emphasizes CMS methodologies, cross-functional collaboration, and timely readouts in a hybrid NY/NJ/CT environment.

Qualifications

• 6-10 years in risk adjustment and/or healthcare analytics.
• Deep expertise in Medicare Advantage risk adjustment, HCC modeling, and CMS methodologies.
• Strong knowledge of value-based care contracts, policy, operations, and financial methods.
• Proficiency with SAS, SQL, and data mining tools.
• Bachelor's degree required (Master's preferred).

Responsibilities

• Lead risk adjustment analytics with an initial emphasis on Medicare Advantage and Medicare.
• Track risk-score movement and flag anomalies using CMS methodologies.
• Build dashboards and concise reports for internal and external stakeholders.
• Collaborate with Performance, Finance and data engineering to ensure reliable data.
• Translate complex data into clear insights to guide forecasting and decisions.

Skills

Risk adjustment

Healthcare analytics

Value-based contracts

CMS methodologies

Education

Bachelor's degree

Master's preferred

Tools

SAS

SQL

Data mining tools

Job description

Position:Manager of Risk Adjustment Analytics

Location:Hybrid (Must Reside in NY/NJ/CT)

Work Schedule:Monday - Friday, 9:00am - 5:00pm

Compensation:$135,292.44 - $152,204.00 Annual Salary

Our Organization

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services.

Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Scope of the Role

The Manager of Risk Adjustment Analytics strengthens VillageCare Max's ability to monitor and improve performance in shared savings arrangements across Medicare Advantage, Medicaid, commercial, and traditional Medicare. This role exists to translate complex risk adjustment and value-based care data into clear insights that guide forecasting, operational decisions, and improvement priorities.

Key responsibilities include leading risk adjustment analytics with an initial emphasis on Medicare Advantage and Medicare; tracking risk-score movement and flagging anomalies; applying expert knowledge of CMS/HCC methodology and claims-based data; building dashboards and concise reporting for internal and external stakeholders; and collaborating with Performance, Finance, and data engineering teams to ensure data is reliable and analysis-ready.

Required qualifications:

• 6-10 years in risk adjustment and/or healthcare analytics
• Deep expertise in Medicare Advantage risk adjustment, HCC modeling, and CMS methodologies
• Strong knowledge of value-based care contracts, policy, operations, and financial methods
• Proficiency with SAS, SQL, and data mining tools
• Bachelor's degree required (Master's preferred)

A Typical Workday

Your day is structured around focused analysis time and cross-functional touchpoints. You may start by reviewing updated risk score outputs and trend views, then align with Performance and Finance partners on what leaders need explained or forecasted for upcoming contract discussions. Midday often includes refining visualizations so insights are easy to interpret, followed by working sessions with data ingestion and engineering to validate claims availability and resolve data questions before conclusions are shared.

As the day progresses, you synthesize findings into a clear narrative-what changed, why it matters, and what actions are implied-then prepare materials for stakeholder readouts. In this fast-paced environment, you balance detail-oriented validation with timely delivery, supporting VillageCare Max's learning and improvement across shared savings programs.