Lead Director, Risk Adjustment Informatics

Job not on LinkedIn

🔥 25 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

🎲 Risk

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead Medicare Advantage and ACA risk adjustment analytics, predictive modeling, intervention strategy, and financial valuations. • Manage a high-performing team with backgrounds in data, analytics, and informatics. • Direct the prioritization and performance evaluation of outreach, engagement, and clinical documentation initiatives. • Develop and implement advanced predictive analytics and AI solutions. • Ensure adherence to CMS regulations, data governance policies, and organizational compliance expectations. • Lead, mentor, and develop a high-performing team of leaders and individual contributors across analytics, informatics, data science, and related disciplines.

🎯 Requirements

• 10 + years of experience in healthcare analytics, informatics, risk adjustment, actuarial, finance, data science, or related disciplines. • 2+ years of leadership experience (direct reports, team lead) • Advanced technical proficiency in SQL, SAS, Python, BigQuery, or similar • Experience with predictive analytics, machine learning, financial modeling, or data science concepts • Demonstrated ability to influence leadership and deliver measurable business results

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package