[Remote] Principal, Risk Adjustment Analytics Consultant - REMOTE

Note: The job is a remote job and is open to candidates in USA. Health Care Service Corporation (HCSC) is a purpose-driven company focused on employee development and success. The Principal Risk Adjustment Consultant will drive analytical strategies to optimize Medicare Risk Adjustment performance, delivering insights and visualizations while advising internal stakeholders and senior leadership.

Responsibilities

• Drives analytical strategies and solutions to optimize Medicare Risk Adjustment (RA) performance
• Delivers actionable insights
• Builds dynamic visualizations
• Provides strategic advisory services to internal stakeholders and senior leadership
• Analyses for revenue optimization
• Risk forecasts
• HCC coding logic
• RADV audits
• Medicare segmentation
• Data & logic governance
• Build interactive visualizations
• Interpret CMS model updates that affect organization-wide strategy and risk adjustment analytics
• Translate highly technical coding, regulatory, and statistical nuances into clear business recommendations for executive leadership

Skills

• Bachelor's degree and 8 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree with 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR PhD with 4 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR 12 years of experience in health care services, statistical analysis, or insurance industry economics or related field
• Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights
• Strong analytical skills and proficiency in computer languages, such as SQL, Python, R, etc
• Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI
• High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution
• Excellent communication and presentation skills
• Ability to work independently and as part of a team
• Ability to lead multiple analytic related projects in parallel
• Analytics subject matter expert
• Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life
• Ability to work under pressure and delivery high quality output to senior leadership to decision making within short timeline
• Deep experience with Medicare Risk Adjustment and Stars
• Advanced analytics & automation using Alteryx or Airflow for data blending and automation
• Proficiency with GitHub for collaborative coding and version control
• Certification or practical experience with project management methodologies and tracking tools (e.g., Agile, Wrike, PMP), and exposure to data science in healthcare including hands-on experience working with predictive models, machine learning pipelines, or Large Language Models (LLMs)

Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Other incentives
• Annual incentive bonus plan subject to the terms and the conditions of the plan

Company Overview

Company H1B Sponsorship