Senior Manager, Health Business Analytics – Medicare Risk Adjustment

GuideWell Source

Manages analytics and strategy implementation for Medicare Risk Adjustment Programs at Florida Blue. Leads team to optimize program outcomes and ensure regulatory compliance.

Posted 6/3/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $119,400 - $194,000 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medicare Risk Adjustmentrisk adjustment programsstatistical methodologiesSQLSASquantitative risk score analysisExcelalgorithmsinferential statisticsbusiness process knowledge

Soft Skills

leadershipcommunicationnegotiatingconsensus buildingpresentationfacilitationconflict resolutioncoachingemployee motivationeffective knowledge sharing

Certifications & Qualifications

Bachelor's degree

Industry Keywords

health businessrisk score projectionstrend analysisrevenue assumptionsstrategy implementationbusiness outcomespolicy and procedure managementemployee moraleprofessional growthanalytics strategy

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Manages a team through providing oversight, strategy implementation and execution for Medicare Risk Adjustment Programs.
Oversee the end-to-end strategy for risk adjustment programs, including prospective and retrospective processes.
Partner with actuarial and finance teams to support bid development, producing defensible risk score projections, trend analysis, and revenue assumptions.
Manage work to produce customer value by planning and forecasting, setting objectives and priorities, establishing goals, clarifying accountabilities, assigning work and utilizing management and financial controls.
Lead analysis, provide recommendations, and represent Analytics.
Work closely with leaders across business areas to drive results across the business.
Manage levels of performance and assist with employees’ professional growth by planning and building an effective organization; communicating effectively; coordinating with others; maintaining employee morale; motivating, recognizing and rewarding others; coaching and developing others, and engaging in self-development.
Manage business and public relationships and situations to obtain better business outcomes; communicate effectively and coordinate with others.
Develop, prioritize and implement strategy; set policies and procedures and manage creativity and innovation with primary goal of impacting health business.

Requirements

What you’ll need

8+ years related work experience. Experience Details: Strong Risk Adjustment experience in commercial and or Medicare.
3+ years direct supervisory/management experience
Related Bachelor’s degree or additional related equivalent work experience
Experience working with statistical methodologies and risk adjustment
Experience writing SQL /SAS or related code to perform quantitative risk score analysis
Advanced Excel skills
Experience using algorithms and inferential statistics.
Expert consulting, negotiating, communicating, consensus building, presentation and facilitation skills
In-depth business process knowledge of several key business functional areas
Expert-level ability communicating highly complex information clearly and articulately for all levels and audiences
Demonstrated leadership abilities including effective knowledge sharing and conflict resolution
Experience communicating and presenting detailed business and financial information
Ability to understand overall Analytics strategy and apply/implement the strategy in assigned projects/initiatives/programs

Benefits

Comp & perks

Medical, dental, vision, life and global travel health insurance;
Income protection benefits: life insurance, short- and long-term disability programs;
Leave programs to support personal circumstances;
Retirement Savings Plan including employer match;
Paid time off, volunteer time off, 10 holidays and 2 well-being days;
Additional voluntary benefits available;
A comprehensive wellness program