Lead Director, Risk Adjustment Performance Reporting and Insights
Core
Lead enterprise risk adjustment analytics and business intelligence solutions to transform complex clinical, operational, and risk adjustment data into actionable insights for provider performance and executive decision-making.
Role type
Senior IC Lead Director (Risk Adjustment Performance Reporting & Insights)
Builds
Enterprise dashboards, reporting tools, and advanced visualizations for risk adjustment KPIs, trends, and performance drivers.
Domain
Healthcare / Risk Adjustment / Business Intelligence
Deliverable
dashboards & analysis
Required skills
Healthcare analytics, informatics, performance insights, actuarial science, value-based care, business intelligence, SQL, Python, Power BI, Tableau, QuickSight, data storytelling, advanced visualizations, AI/automation adoption, predictive analytics, KPI governance, team leadership, stakeholder management.
Preferred skills
Medicare/Medicaid/ACA risk adjustment methodologies, HCC models, CMS regulatory requirements, health plan or provider system experience, Master's degree in Business/Informatics/Analytics/Finance/Statistics/Computer Science/Public Health/Healthcare analytics/Actuarial/Mathematics/Economics.
Responsibilities
Account for timely and accurate sharing of risk adjustment KPIs, trends, and performance drivers at a market, plan, and provider level through dashboards and reporting tools; Quantify drivers of risk movement and surface those insights to business leaders for action; Develop and oversee provider performance analytics that deliver actionable insights into gap closure, engagement, and overall risk adjustment outcomes; Lead in the adoption of AI, advanced analytics, automation, and modern business intelligence capabilities; Lead, mentor, and develop a high-performing analytics and business intelligence team (approx. 4-5 direct reports and overall scope 7-8 employees).
Seniority
Director, hands-on IC with leadership responsibilities
