Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Core
Strategic and operational leadership for Medicaid risk adjustment analytics, reporting, and informatics to ensure accurate revenue capture and compliance.
Role type
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Builds
Scalable data pipelines, reporting frameworks, and predictive models for risk score development and reconciliation.
Domain
Healthcare Payer / Medicaid Risk Adjustment / Health Informatics
Deliverable
production ML models | dashboards & analysis | client delivery
Required skills
Medicaid risk adjustment strategy, risk score reconciliation, predictive modeling, data pipeline development, regulatory compliance, team leadership, cross-functional stakeholder management, advanced analytics, data visualization
Preferred skills
Master's degree in Health Informatics/Data Science/Actuarial/Statistics/MBA, experience in large national health plan
Technologies
SAS, SQL, Python, BigQuery, Snowflake, Databricks, Tableau, Power BI, QuickSight, Looker
Responsibilities
Define and execute Medicaid risk adjustment strategy across markets; oversee health plan performance using advanced analytics; lead development of scalable data pipelines and reporting frameworks; establish processes for risk score integrity and reconciliation; lead and develop a multidisciplinary team spanning informatics and analytics.
Seniority
Director, strategic & operational leadership