Managing Dir, Risk Adj Analytics & Encounters

Emergent Holdings; United States; On-site; USD 191,300 - 320,300; Full time

Job summary

A leading healthcare firm in the United States is seeking a Managing Director for Risk Adjustment Analytics and Encounters. The ideal candidate will oversee key analytics teams, provide expertise in revenue cycle planning, and possess strong leadership and analytical skills with a focus on healthcare settings. A combination of technical experience and management capability is essential for success in this role. The estimated pay range for this position is between $191,300 and $320,300.

Qualifications

• Ten years of experience in a Health Care environment.
• Five years of management or supervisory experience in Health Care.
• Medicare Advantage revenue experience strongly preferred.

Responsibilities

• Oversee Directors and analytics support staff.
• Lead analytic expertise for revenue cycle capital planning.
• Develop and maintain detailed actuary modeling.

Skills

Leadership in risk adjustment services

Analytical skills

Presentation skills

Team-oriented mindset

Problem-solving skills

Education

Bachelor’s degree in a related field

Master’s degree preferred

Tools

Tableau

Job description

Managing Director, Risk Adjustment Analytics & Encounters

Emergent Holdings

Join to apply for the Managing Director role at Emergent Holdings.

Responsibilities

• Oversee Directors, Actuarial and analytics support staff, and senior technical personnel.
• Lead and direct the organization, providing analytic expertise that drives revenue cycle capital planning decisions.
• Develop, enhance and maintain detailed actuary modeling to support bid, budget and forecasting cycles, KPI scorecard reporting, settlement and year‑end accruals, and executive level reporting and dashboard.
• Evaluate and provide performance reporting and insights on prospective, retrospective, and submission/encounter program impacts which drive operational improvements.
• Support Actuarial, Finance, HCV and other teams based on modeling request and RA performance insights for existing or new contract opportunities.
• Create, enhance and maintain provider reporting and analytics, including chronic condition persistency/recapture rates and PO level HCC capture improvement opportunities.
• Provide risk adjustment education to external and internal stakeholders including key accounts and Group.
• Direct development of corporate standards and review of tools and technologies for improving performance and reducing costs.
• Represent the company in community and industry programs and conferences.
• Participate in development of annual departmental budget, monitor budget and identify budget discrepancies.

Qualifications

• Bachelor’s degree in a related field (Master’s preferred).
• Ten (10) years of progressively responsible experience in a Health Care environment with demonstrated technical experience.
• Five (5) years of management or supervisory experience in Health Care.
• Medicare Advantage revenue experience strongly preferred.
• Experience with Managed Care environment preferred.
• Strong experience with Tableau and expertise in executing complex projects.
• Proven leadership in risk adjustment services, client engagement, operational processes and compliance.
• Strong analytical skills, presentation skills and ability to build consensus across all levels of the organization.
• Team‑oriented, self‑ with a can‑do attitude and excellent problem‑solving skills.

Pay Range

Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. A reasonable estimate for this role is between $191,300 and $320,300.

EEO Statement

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability. Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.