Senior Risk Adjustment Vendor Performance Manager

100 Horizon Healthcare Services, Inc; Newark (NJ); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Health benefits

Retirement plans

Generous PTO

Wellness programs

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a senior analytics professional to lead vendor management and performance measurement for Enterprise Risk Adjustment. You will drive KPI frameworks, negotiate contracts, and partner with commercial, Medicare, and Medicaid programs to optimize vendor outcomes.

The role requires 6+ years in healthcare analytics, strong financial modeling and data analysis skills, and experience with SAS, R, or SQL.

Qualifications

• Bachelor’s degree preferred in business, finance, statistics, healthcare, or related field.
• 6+ years healthcare or insurance experience with analytics/reporting.
• 3+ years supervisory experience.
• Extensive knowledge of risk adjustment and vendor performance management.

Responsibilities

• Develop and lead risk adjustment vendor strategy aligned to enterprise goals.
• Identify vendor needs, source and evaluate partners, and define success measures.
• Negotiate contracts and own day-to-day vendor relationships.
• Lead RFPs, vendor selection, implementation, and offboarding.
• Manage onboarding and wind-down activities including data retention and destruction.
• Design and maintain KPI frameworks for vendors and internal operations.
• Develop models and reporting to measure financial impact and operational outcomes.
• Audit internal and vendor reporting for accuracy and completeness.

Skills

Vendor Management

Risk Adjustment

Analytics

KPI Development

Financial Modeling

Contract Negotiation

Data Analytics

Stakeholder Management

Regulatory Awareness

Education

Bachelor’s degree preferred in business, finance, statistics, healthcare, or related field

Tools

SAS

R

SQL

Excel

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a senior analytics professional to lead vendor management and performance measurement for Enterprise Risk Adjustment. You will drive KPI frameworks, negotiate contracts, and partner with commercial, Medicare, and Medicaid programs to optimize vendor outcomes.

The role requires 6+ years in healthcare analytics, strong financial modeling and data analysis skills, and experience with SAS, R, or SQL.