Senior Manager, Healthcare Medicaid Risk Adjustment Analytics

CVS Health

Senior Informatics Manager at CVS Health leading advanced analytics and strategies for Medicaid risk adjustment performance. Collaborating with finance, actuary, and analytics teams to improve health plan outcomes.

Posted 6/25/2026full-timeRemote • Idaho, Massachusetts, Texas • 🇺🇸 United StatesSenior💰 $67,900 - $199,144 per yearWebsite

Tech Stack

Tools & technologies

BigQueryCloudGoogle Cloud PlatformPythonSQL

About the role

Key responsibilities & impact

Evaluate health plan performance using advanced analytics to identify trends, gaps, and opportunities across Medicaid populations
Design and execute complex analyses leveraging medical and pharmacy claims, encounter, provider, and membership data
Translate analytical findings into clear, actionable insights to drive health plan strategies and decision-making
Develop and maintain scalable reporting, dashboards, and performance monitoring tools
Support development of data models, forecasting approaches, and performance measurement frameworks
Ensure data accuracy, integrity, and governance across reporting and analytical outputs
Identify and implement process improvements through automation and advanced analytics
Communicate complex findings effectively to both technical and non-technical stakeholders
Support compliance with CMS and state Medicaid requirements through accurate, timely reporting and analysis

Requirements

What you’ll need

8+ years of relevant professional experience in healthcare analytics, including working with claims and encounter data
2+ years of leadership experience managing, coaching, or mentoring team members
Experience with government-regulated healthcare programs (Medicaid, Medicare, and/or ACA)
Advanced technical skills in Google Cloud Platform (GCP)/Big Query, SQL, SAS, Python, or similar programming languages
Demonstrated experience working with large, complex healthcare datasets and performing root cause analysis
Proven ability to manage multiple projects and competing priorities in a fast-paced environment
Strong ability to translate technical analyses into actionable business insights
Excellent communication skills across technical and non-technical audiences.

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

advanced analyticsdata modelingforecastingperformance measurementroot cause analysisSQLSASPythonGoogle Cloud PlatformBig Query

Soft Skills

leadershipcoachingmentoringcommunicationproject managementprioritizationanalytical thinkingproblem-solvingstakeholder engagementprocess improvement