We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Requirements
- Lead analytical initiatives supporting Medicare and CMS Risk Adjustment programs
- Analyze large healthcare datasets (claims, encounters, enrollment, chart reviews, and clinical data) to: Identify RAF optimization opportunities, Monitor coding accuracy and completeness, Assess financial and operational impact of risk score changes
- Develop and maintain SQL‐based data pipelines and analytic models in large data warehouse environments, Produce executive‐level reporting and dashboards addressing: HCC performance, Coding gap closure, Suspect and recapture outcomes, Provider and member impact
- Translate CMS regulations, risk adjustment models, and technical findings into clear business insights, Partner with coding, clinical, compliance, and operational leaders to support risk‐adjustment initiatives
- Serve as a subject matter expert on Medicare data, metrics, and CMS standards, Lead or support analytic projects end‐to‐end, including scope definition, analysis, and stakeholder delivery
Benefits
- Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
To apply for this job please visit cvshealth.wd1.myworkdayjobs.com.
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