Senior Health Data Analytics & Risk Adjustment Lead

CVS Health; Connecticut; On-site; USD 66,000 - 146,000; Full time

Job summary

CVS Health is seeking a seasoned healthcare analytics professional to join the Medicare Risk Adjustment team in a full-time role in the United States. You will lead cross-functional data initiatives, ensure regulatory compliance, and drive data quality and analytics programs across encounter data and HCC analytics.

Requirements include 7+ years in healthcare analytics, 5+ years in Medicare Risk Adjustment or ACA analytics, and proficiency with SQL, SAS, Databricks, cloud platforms, and Power BI.

Qualifications

• 7+ years of healthcare industry experience.
• 5+ years of Medicare Risk Adjustment, EDS, MAO-004, or ACA analytics.
• Experience leading 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.
• Oversee end-to-end Risk Adjustment processes, encounter data validation, HCC analytics, CMS reporting, and data governance.

Skills

Healthcare analytics

Project leadership

Regulatory knowledge

Cross-functional collaboration

Education

Bachelor's degree or related work experience

Tools

SQL

SAS

Databricks

Cloud platforms (GCP/Azure/AWS)

Power BI

Job description

CVS Health is seeking a seasoned healthcare analytics professional to join the Medicare Risk Adjustment team in a full-time role in the United States. You will lead cross-functional data initiatives, ensure regulatory compliance, and drive data quality and analytics programs across encounter data and HCC analytics.

Requirements include 7+ years in healthcare analytics, 5+ years in Medicare Risk Adjustment or ACA analytics, and proficiency with SQL, SAS, Databricks, cloud platforms, and Power BI.