Senior Healthcare Risk Analytics Lead (Hybrid NYC)

Healthfirst; New York (NY); Hybrid; USD 83,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Life insurance

401k contributions

Incentive programs

Job summary

Healthfirst is seeking a Senior Healthcare Analyst, Risk Adjustment to monitor performance, forecast risk scores, and deliver insights for executive leadership. You will partner with Finance, Actuarial, and Network Management to drive accuracy and timely reporting.

The role emphasizes advanced analytics, process automation with Python/SQL, and collaboration across departments in a fast-paced healthcare environment.

Qualifications

• 3+ years of related risk adjustment experience.
• Bachelor's degree or higher in Finance, Accounting, Public Health, Healthcare Policy, or Healthcare Administration.
• Deep understanding of CMS-HCC, HHS-HCC, and/or Medicaid Rx risk adjustment.
• Familiarity with Medicare/Medicaid data submission systems (EDPS, RAPS).
• Strong communication and collaboration skills for cross-functional work.

Responsibilities

• Provide ad-hoc analytical support for Medicare initiatives and risk adjustment drivers.
• Forecast risk scores and assist budgeting; evaluate impact on revenue.
• Develop Python/SQL processes to calculate and validate accruals.
• Collaborate with Finance, Actuarial, Network Management, and stakeholders.
• Summarize complex data into actionable insights for senior leadership.

Skills

Analytical mindset

Collaborative

Project management

Communication skills

Problem solving

Time management

Attention to detail

Education

Bachelor's degree or higher in Finance/Accounting/Public Health/Healthcare Administration

Tools

SAS

Python

R

Tableau

SQL

Job description

Healthfirst is seeking a Senior Healthcare Analyst, Risk Adjustment to monitor performance, forecast risk scores, and deliver insights for executive leadership. You will partner with Finance, Actuarial, and Network Management to drive accuracy and timely reporting.

The role emphasizes advanced analytics, process automation with Python/SQL, and collaboration across departments in a fast-paced healthcare environment.