Sr. Director, Risk Adjustment Data & Analytics; Remote

Job Overview

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Sr. Director, Risk Adjustment Data & Analytics (Remote) is a senior technical and operational leader responsible for advancing the integrity, completeness, and strategic value of Medicare Risk Adjustment (MRA) data and analytics programs within the organization. This role serves as the primary accountable leader for MRA data operations — owning the analytical and data engineering infrastructure that enables suspecting, chart review, coding, submission, and reconciliation workflows to operate king cross‑functionally with MRA Business leadership, Finance, Actuarial, Clinical Operations, Compliance, and enterprise IT teams, this leader ensures that all key stakeholders are working from consistent, trusted, and defensible MRA data.

The role leads a multidisciplinary team of analysts, data scientists, and data engineers, setting analytical standards and translating program outcomes into clear, actionable insights for senior leadership. This role is critical to the organization because Risk Adjustment Factor (RAF) scores directly drive plan revenue, making accurate, timely, and defensible MRA data a high‑stakes organizational priority — and the Senior Director is the operational owner of that capability.

• Lead MRA Data Operations and Ecosystem Quality. Own the end‑to‑end MRA data ecosystem — spanning data ingestion, transformation, validation, reporting, and analytics across all Risk Adjustment programs. Ensure data is timely, complete, and consistently reliable to support all downstream MRA workflows, from prospective suspecting through CMS submission and reconciliation.
• Drive Analytical Insights and Program Performance Reporting. Develop and maintain reporting and analytical frameworks that explain what happened, why it happened, and where to intervene across MRA programs. Translate risk score trends, program impacts, and variance drivers into clear, executive‑ready narratives and data visualizations that enable confident decision‑making.
• Ensure Audit Readiness, Data Governance, and Compliance. Establish and maintain rigorous data governance standards, controls, and documentation to ensure MRA data is audit‑ready, reproducible, and defensible at all times. Partner closely with Compliance to support RADV audits, internal reviews, and CMS regulatory requirements — including full traceability of submissions and supporting evidence.
• Partner Strategically with Finance, Actuarial, and Clinical Stakeholders. Serve as the primary MRA data partner to Finance and Actuarial teams, providing clarity on risk adjustment program performance, revenue impacts, and variance drivers. Support Clinical Operations and JSA Outreach teams with data that enables precise member identification, chart retrieval coordination, and coding accuracy.
• Direct and Develop the MRA Analytics Team. Lead, grow, and develop a multidisciplinary MRA data team spanning analytics, data science, and data engineering disciplines. Establish clear accountability structures, promote a culture of quality and continuous improvement, and ensure team outputs meet the technical and operational standards required for a highly regulated environment.
• Identify and Remediate Data Quality and Process Gaps. Proactively identify gaps in data quality, timeliness, or workflow execution and drive corrective actions through system improvements, tooling enhancements, or process redesign. Set and enforce technical and analytical standards — including definitions, assumptions, and validation…