Vendor Performance Lead - Risk Adjustment & Analytics

Sokoni Kwetu Limited; United States; On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a senior analytics professional to lead vendor management, performance measurement, and analytics for Enterprise Risk Adjustment. You will drive strategy, ensure accurate KPI reporting, and partner cross-functionally to optimize vendor and operational performance across Commercial, Medicare, and Medicaid programs.

You will design KPI frameworks, negotiate contracts, mentor analytics teams, monitor vendor spend and invoices, and present

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.

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.
• Analyze performance trends and identify improvement opportunities.
• Audit internal and vendor reporting for accuracy and completeness.
• Ensure data integrity and adherence to measurement standards.

Skills

Vendor Management

Risk Adjustment Analytics

KPI Development

Financial Modeling

Contract Negotiation

Data Analytics

Stakeholder Management

Regulatory Awareness

Education

Bachelor’s degree

Tools

SAS

R

SQL

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a senior analytics professional to lead vendor management, performance measurement, and analytics for Enterprise Risk Adjustment. You will drive strategy, ensure accurate KPI reporting, and partner cross-functionally to optimize vendor and operational performance across Commercial, Medicare, and Medicaid programs.

You will design KPI frameworks, negotiate contracts, mentor analytics teams, monitor vendor spend and invoices, and present