Manager, Risk Score Accuracy
HybridMedicaidLong Term CareHealth OtherPredictive Modelling & MLBusiness Intelligence & ReportingExperience Studies
Role Summary
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Manager-level health analytics role focused on risk score accuracy and forecasting for NY Medicaid and related products. You will build and maintain risk score forecasting models, analyze claims/grouper impacts, and communicate results to clinical leaders and hospital management. Hybrid role based in New York City (3 days onsite).
JOB DESCRIPTION SUMMARY
- Manage risk score forecasting for NY Medicaid, Essential Plan, HARP, CHPlus and MLTC
- Build and maintain forecasting models; analyze claims and grouper impacts
- Use SQL (PostgreSQL, MS SQL, MySQL) and advanced Excel; Tableau/Power BI for visualization
- Hybrid role — 3 days on-site at 100 Church Street, New York, NY
- Manager-level role requiring 5+ years in risk adjustment/grouper analysis
DOMAIN EXPERTISE
- risk adjustment and grouper analysis
- Medicaid/HHS risk adjustment payment methodologies
- modeling enterprise impact of risk/value-based revenue changes
- supporting product and actuarial analytical requests
KEY REQUIREMENTS
- Bachelor's degree required
- 5+ years' experience in risk adjustment or grouper/statistical clinical analysis
- Experience with Medicaid/HHS risk adjustment payment methodologies
- Proficiency in SQL (PostgreSQL, MS SQL Server, MySQL) and advanced Excel
- Data visualization experience (Tableau, QlikView, or Power BI)
TECH STACK
- Excel
- Tableau
- Qlikview
- Power_BI
