Consultant - Risk Adjustment Operations
Medicare AdvantageACA ExchangeBusiness Intelligence & ReportingRegulatory ReportingUW Support & Portfolio Management
Role Summary
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Health consulting role focused on ACA and Medicare Advantage risk adjustment operations across health plans. You will manage client engagements, perform data analysis and financial modeling, and coordinate cross-functional teams. Consultant I level, client-facing, based in the United States.
JOB DESCRIPTION SUMMARY
- Client-facing consultant supporting ACA and Medicare Advantage risk adjustment operations
- Manage project timelines and deliverables across multiple client engagements
- Perform data analysis and develop financial models to inform client strategies
- Collaborate with actuarial, coding, data engineering, and operations teams
- Support business development including RFPs and proposal preparation
DOMAIN EXPERTISE
- ACA and Medicare Advantage risk adjustment operations
- Risk adjustment lifecycle including coding, submissions, analytics, and provider engagement
- Healthcare consulting or actuarial analysis experience
KEY REQUIREMENTS
- Deep experience supporting or leading ACA and Medicare Advantage risk adjustment operations
- Minimum of 2 years of healthcare consulting, actuarial analysis, or related experience
- Bachelor’s degree in math, statistics, economics, actuarial science, or related field required
- Strong client communication and project management skills
- Proficiency in Excel; experience with SAS, R, or SQL preferred
TECH STACK
- Excel
- SAS_Enterprise_Guide
