Senior Risk Score Data Analyst

Mass General Brigham; Somerville (MA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare organization seeks a Risk Adjustment Manager to lead projects and improve risk strategies. The role offers competitive salary, flexible work options, and the chance to collaborate with top professionals in the field. Ideal candidates will have significant experience in risk adjustment and strong analytical skills.

Benefits

Flexible work options

Career advancement opportunities

Qualifications

• Minimum of 3-5 years of risk adjustment experience.
• Experience leading complex projects and presenting analytics.

Responsibilities

• Lead all internal and external risk adjustment projects.
• Manage vendor relationships and assist in negotiating contracts.
• Communicate directly with executive leadership regarding analytics.

Skills

Analytical Skills

Collaboration

Education

Bachelor’s Degree

Master’s Degree

Job description

Employer Industry: Healthcare

Why consider this job opportunity:
- Competitive salary with opportunities for career advancement and growth within the organization
- Flexible work options, including remote work capabilities
- Collaborative environment that values diversity, equity, and inclusion
- Chance to work with leading professionals in the healthcare industry
- Opportunity to influence and improve risk adjustment strategies within the organization

What to Expect (Job Responsibilities):
- Lead all internal and external risk adjustment projects from conception to implementation
- Manage vendor relationships and assist in negotiating contracts
- Develop and present complex analytics related to financial performance
- Communicate directly with executive leadership regarding risk adjustment analytics
- Ensure compliance with CMS and MassHealth requirements while participating in audits

What is Required (Qualifications):
- Bachelor’s degree or equivalent combination of training and experience; Master's degree preferred
- Minimum of 3-5 years of risk adjustment experience
- Experience leading complex projects and presenting analytics to executive-level stakeholders
- Knowledge of HHS Commercial Risk Adjustment, ACA, CMS Risk Adjustment, and MassHealth risk adjustment
- Medical coding certification or equivalent experience preferred

How to Stand Out (Preferred Qualifications):
- 1-2 years of leadership experience preferred
- Previous experience with CMS risk adjustment audits (RADV) preferred
- Strong analytical skills with the ability to identify patterns in complex medical data
- Proven ability to collaborate with healthcare professionals to improve clinical documentation
- Experience in driving organizational change related to risk adjustment programs

#Healthcare #RemoteWork #RiskAdjustment #CareerGrowth #DiversityAndInclusion

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