Principal Health Business Analytics - Risk Adjustment
Florida Blue
Principal Health Business Analytics - Risk Adjustment
United States•5mo ago
Medicare Advantage
Role Summary
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Senior health analytics role focused on Medicare Risk Adjustment at a US health insurer. You will lead analytic strategy, analyze risk score and model performance, and partner with Finance and Actuarial to forecast revenue and evaluate CMS model impacts. The role requires strong SQL/SAS and advanced Excel skills and involves mentoring analysts and presenting insights to senior leadership.
JOB DESCRIPTION SUMMARY
- Lead analytic strategy and execution for Medicare Risk Adjustment programs
- Analyze risk score trends, model performance, and forecast CMS impacts
- Build advanced SQL/SAS extracts and Excel-based models from large datasets
- Mentor analysts and advance predictive modelling, automation, and dashboards
- Senior role requiring 8+ years experience with health business exposure
DOMAIN EXPERTISE
- Risk adjustment analytics
- Medicare/CMS model impact analysis (e.g., V24 → V28)
- Advanced SQL/SAS programming for large datasets
- Advanced Excel modelling and financial forecasting
- Health business operational and vendor/program evaluation
KEY REQUIREMENTS
- 8+ years of related work experience
- 4+ years of experience with health business
- Advanced SQL and/or SAS programming experience
- Advanced Excel modelling and forecasting skills
- Proven ability to lead high-impact analytics and mentor others
TECH STACK
- Excel
- PowerPoint
