Data Analytics Manager - Risk Adjustment (Hybrid

PURPOSE

Purpose of the Manager, Data Analytics is to execute business objectives with the Health Services' Risk Adjustment team. This position leads the analysis, reporting, and performance monitoring activities that support the organization's Risk Adjustment programs. The role is responsible for directing the development of trusted data assets, producing actionable reporting and insights, and leveraging advanced analytics to improve program outcomes through collaboration with clinical, operational, financial, and technology teams.

Responsibilities include oversight of key performance metrics, risk score forecasting, member and provider targeting strategies, dashboard and reporting solutions, CMS, HHS, and MDH reconciliation activities, and ad hoc analyses to identify opportunities for enhanced program performance and operational efficiency. The ideal candidate will possess a strong understanding of Medicare Advantage, ACA, and Medicaid risk adjustment methodologies, along with a commitment to data governance, compliance, and analytical excellence.

Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction.

Purpose of the Manager, Data Analytics is to execute business objectives with the Health Services' Risk Adjustment team. This position leads the analysis, reporting, and performance monitoring activities that support the organization's Risk Adjustment programs. The role is responsible for directing the development of trusted data assets, producing actionable reporting and insights, and leveraging advanced analytics to improve program outcomes through collaboration with clinical, operational, financial, and technology teams.

Responsibilities include oversight of key performance metrics, risk score forecasting, member and provider targeting strategies, dashboard and reporting solutions, CMS, HHS, and MDH reconciliation activities, and ad hoc analyses to identify opportunities for enhanced program performance and operational efficiency. The ideal candidate will possess a strong understanding of Medicare Advantage, ACA, and Medicaid risk adjustment methodologies, along with a commitment to data governance, compliance, and analytical excellence.

Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction.

This role requires candidates to be located in the Maryland, Washington, DC, or Northern Virginia (DMV) area who are willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and at least two days a week at a Care First location based on business needs and work activities/deliverables that week.

• Manage a team with a focus on the development of analytics capabilities across the company, including self-service capabilities through technology implementation, best practices and training. Ensure team members serve as a trusted advisor to clients on analytics and data.
• Interpret statistical analyses and help clients derive meaning from them.
• Develop and deliver presentations and reports of analytic findings
• Develop hypotheses and research questions to address clients' needs. Conduct a wide range of quantitative, qualitative, and mixed-methods analyses to develop required reporting.
• Develop analytic frameworks and select appropriate analytic methods needed for all deliverables.
• Partner with stakeholders to understand data requirements and with internal and/or external resources to develop tools and services such as…