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Role Summary

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HIGHLIGHTS

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
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Role Summary

Loading...

HIGHLIGHTS

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

Job Overview

Salary
$103k - $149k
Years of Experience
5+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Manager-level health analytics professional with 5+ years in risk adjustment for Medicaid/MLTC, comfortable building SQL-based forecasting models and communicating findings to clinical and senior stakeholders; ASA credential preferred.

Benefits

Health InsuranceDental InsuranceVision InsuranceBonus EligibleLife Insurance401(k) PlanHybrid Work
Shortlist Forming
Closing Soon
73d
73 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Job Overview

Salary
$103k - $149k
Years of Experience
5+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Manager-level health analytics professional with 5+ years in risk adjustment for Medicaid/MLTC, comfortable building SQL-based forecasting models and communicating findings to clinical and senior stakeholders; ASA credential preferred.

Benefits

Health InsuranceDental InsuranceVision InsuranceBonus EligibleLife Insurance401(k) PlanHybrid Work
Shortlist Forming
Closing Soon
73d
73 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Health/Insurer/Manager Level
Healthfirst. Inc.

Manager, Risk Score Accuracy

Healthfirst. Inc.•United States•2mo ago
HybridMedicaidLong Term CareHealth OtherPredictive Modelling & MLBusiness Intelligence & ReportingExperience Studies

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