Risk

• Conduct advanced data analysis
• Build and maintain HCC performance reporting
• Support predictive modeling initiatives
• Monitor vendor performance
• Design, develop, and maintain risk adjustment performance dashboards and reports using Power BI, Tableau, or equivalent tools to monitor KPIs
• Write and optimize complex SQL queries to extract, transform, and analyze large datasets
• Support the development and validation of predictive models for HCC suspecting, risk score forecasting, and provider performance stratification
• Prepare and present analytical findings, trend analyses, and performance summaries to key internal stakeholders
• Mentor junior analysts and coordinators
• Maintain active relationships with customers to determine business requirements

Senior Risk Adjustment Analyst

• Oversee day-to-day operations and strategic execution of enterprise risk adjustment programs
• Assist management overseeing risk adjustment programs including claims, vendor quality, and audits
• Develop metrics, policies, and procedures for validation of programs return on investment
• Collaborate with operations risk and compliance teams for implementing initiatives
• Provide oversight and ensures accurate coding for Medical Revenue Management programs
• Serve as a subject matter expert on coding
• Work collaboratively with Enterprise Risk Adjustment team, Business Operations, Regulatory Compliance, and Internal Audit
• Influence others and work effectively to develop relationships with stakeholders

Risk Adjustment Strategic Manager

• Performs workplace/work site risk evaluation and consultative risk improvement services
• Provides risk assessment information on complex accounts to support underwriting process for prospective, new and renewal accounts
• Submits corresponding Risk Control recommendations or business solutions to minimize identified exposures
• Assesses customer's risk control program needs and develops and executes a customized strategy and supporting implementation plan for further refinements or improvements
• Makes recommendations on the development and implementation of risk control policy, marketing and business strategy
• Develops and maintains business relationships with internal and external business partners
• Develops and conducts education, training, and presentations
• Provides expertise in specialty area to both internal and external customers
• Conducts agency/broker visits

Risk Control Consultant

• Develop and execute a comprehensive safety and risk management strategy for all corporate and franchise operations
• Establish safety standards, policies, procedures, and best practices that support operational excellence and risk reduction
• Create and manage company-wide safety scorecards, KPIs, dashboards, and reporting systems
• Lead initiatives designed to reduce workplace injuries, vehicle accidents, cargo claims, and insurance losses
• Foster a culture of accountability, leadership, and safety ownership across all levels of the organization
• Provide executive leadership with regular reporting and recommendations regarding safety trends, risks, and corrective actions
• Serve as the organization's primary authority on regulatory compliance and monitor regulatory changes
• Oversee the company's captive insurance programs and risk management initiatives
• Analyze workers' compensation, auto liability, general liability and cargo claims and implement proactive loss prevention strategies
• Develop and deliver safety certification programs for franchise owners and operational leaders
• Build and lead a high-performing safety and risk management function

Director of Safety and Risk Management

• Responsible for evaluating, marketing, negotiating, and placing commercial insurance new business opportunities
• Review submissions, obtain and compare quotes, negotiate pricing and coverage terms
• Guide opportunities through the placement process from submission to binding
• Develop productive business relationships with insurance carriers, underwriters, and internal producer partners
• Execute placement strategies utilizing carrier relationships and available market resources

Senior Risk Placement Specialist – Commercial Insurance

• Provide enterprise leadership to design, standardize, and improve the end to end operating model across HEDIS and Risk Adjustment
• Drive improvements in data collection, processing, encounter creation and management, submission controls, reconciliation, and audit readiness
• Ensure execution across internal teams, technology partners, analytics, finance, and external vendors is aligned and coordinated
• Establish and maintain governance structures for regulatory compliance, audit readiness, and defensible outcomes
• Own the end to end vendor operating model for Risk Adjustment
• Serve as the primary integrator across Quality, Performance Outcomes, Technology, Data, Analytics, Finance, Actuarial, Provider Quality, and external partners

Senior Director, Risk Adjustment

• Directly manage and develop a team of analysts performing EDD reviews of varying complexity; set performance expectations, provide coaching, and complete performance feedback processes
• Own daily operations and workload planning (intake, assignment, prioritization, and capacity planning) to ensure reviews are completed within SLA timeframes
• Establish and monitor team performance metrics (timeliness, productivity, quality) and drive corrective actions where needed
• Oversee case assignment and case status management; remove blockers and coordinate rework for quality issues
• Lead a quality control and sampling program for completed EDD reviews; identify root causes, document findings, and implement training and process improvements
• Maintain and refine team procedures, process flows, templates, and job aids; ensure changes are communicated and adopted consistently
• Partner with first-line business units and internal stakeholders to obtain required customer information and documentation; ensure requests are clear, appropriately risk-based, and timely
• Manage escalations of financial crime red flags and unusual activity; ensure appropriate risk decisions, documentation, and handoffs (e.g., SAR investigation referral) occur in accordance with policy
• Support leadership in maturing the EDD/HRC program by recommending process enhancements, tooling opportunities, and risk-based approaches that improve defensibility and efficiency
• Provide reporting and analysis on pipeline health, trends, and recurring issues to management; escalate emerging risks and capacity concerns
• Coordinate audit, compliance testing, and exam support for the team, including evidence gathering, response drafting, and remediation of findings
• Lead and/or support ad hoc projects and initiatives as assigned.

Manager, BSA – High Risk Customer Reviews

• Provide leadership and subject matter expertise for the organization’s Enterprise Risk Management (ERM) function, ensuring it continues to mature in alignment with organizational strategy, operating context, and governance expectations
• Advise the Senior Leadership Team (SLT) and the Audit & Risk Management Committee (ARC) on enterprise risk matters, supporting a dynamic, forward‑looking approach to identifying, prioritizing, and managing risk
• Strengthen enterprise‑level operational resilience by ensuring the SLT has a clear view of the organization’s most significant risks, including changes over time and the effectiveness of mitigation strategies
• Partner with SLT Risk Owners to review evolving risk assessments; develop, document, and periodically refresh critical mitigation plans; identify emerging risks and potential new mitigations; and assess whether additional organizational support or resources are needed
• Serve as the focal point for engagement with SCI on shared and interdependent risks, ensuring those risks are clearly understood, consistently assessed, and appropriately managed across organizational boundaries
• Design, produce, and deliver high‑impact enterprise risk reporting for the SLT and ARC, emphasizing trends, interdependencies, emerging risks, and actionable insights rather than static risk inventories
• Lead targeted “Deep Dive” analyses on priority risk themes, providing the Board and leadership with the transparency, context, and analysis needed to govern confidently—particularly during periods of strategic, operational, or external change
• Support alignment and integration across risk‑related second- and third-line functions to promote a coherent, enterprise‑wide understanding of risk and avoid unnecessary duplication or burden
• Embed risk‑aware thinking across the organization by developing practical tools, templates, guidance, and training that enable staff at all levels to identify, discuss, and manage risk in a proportionate and constructive way
• Serve as an accessible resource and thought partner to teams across the organization, supporting risk‑informed decision‑making while ensuring the ERM function adds value and does not create unnecessary organizational drag

Lead Advisor, Enterprise Risk Management

• The Information Architecture Governance Advisor owns the design and implementation of an enterprise information model.
• Establishes and carries out enterprise data and information architecture policies, standards, and processes according to guidelines.
• Is responsible for structuring, organizing, and communicating information in a way that makes it easy for business users to find, navigate, and understand.
• Champions and facilitates the review of data-related changes across the organization.
• Works with business partners and Information Technology (IT) partners to drive consensus around how data should be structured.
• Define criteria and controls for an authoritative data source (ADS)
• Lead the design and implementation of information modeling practices for the enterprise
• Define data and information architecture related standards and guidelines
• Coordinate and facilitate the review of data-related changes from an enterprise perspective
• Organize data within domains and sub-domains to enhance the ability to find, govern, and utilize data across the enterprise
• Enhance the company’s data governance platform to include data and information architecture components, definitions, and relationships
• Support enterprise data strategy and data governance programs by providing a structured approach to architectural decision-making, ensuring changes are evaluated based on their impact across the enterprise
• Identify and mitigate risks associated with architectural decisions and implementations
• Establish guidelines and standards to minimize risks while ensuring compliance with regulations and policies
• Act as liaison between business and IT to translate business data requirements into logical data architecture design
• Engage in the development of policies, standards and procedures and coordinate with stakeholders through the approval process
• Ensure compliance with established standards for development and management of data
• Ensure compliance to data-related regulatory rules
• Perform regular peer review of information models used across the enterprise

Information Architecture Governance Advisor

• Performs underwriting evaluation of residential mortgage loan applications to ensure compliance with underwriting guidelines and alignment with organizational risk standards.
• Applies expertise across conventional and government‑backed loan products and demonstrates working knowledge of the full mortgage loan lifecycle, including closing, post‑closing, and pooling.
• Utilizes strong analytical, process facilitation, and project management skills to support sound decision‑making, effective stakeholder communication, and workforce planning.
• Demonstrates business risk awareness, credible business acumen, effective presentation and relationship‑building skills, and proficiency with standard business technology tools.

Business Risk Professional

• Learn to perform duties in Risk Management under general supervision.
• Support risk management activities related to risk assessments and practices.
• Conduct non-financial risk assessments and risk reviews.
• Support GRC software activities.
• Synthesize data into actionable insights from large amounts of data across multiple systems.
• Collaborate frequently with other areas of the credit union.

Risk Management Intern

• Build and maintain matching, concordance, and survivorship processes
• Develop data quality rules, monitoring, and dashboards
• Perform SQL analysis and Python-based automation/validation
• Manage data issues, track resolution, and support governance workflows
• Partner with engineering teams (e.g., Databricks) and business stakeholders
• Maintain governance documentation, standards, and metrics
• Support CRM data standards and validation processes

Data Governance, MDM Specialist

• Provide value added loss prevention services to our Business Insurance accounts
• Establish and maintain valued risk management relationships with our clients
• Evaluate employee safety exposures and controls and providing effective risk improvement solutions
• Effectively promote our risk control capabilities in new business opportunities
• Assess Automobile/fleet, General Liability and Crime exposures with effective feedback on exposures and controls in place and/or needed
• Develop insightful risk assessment reports for external and internal customers
• Serve as a liaison for loss control activities between client and carrier
• Monitor loss information and analyze trend development; develop effective overview and solutions
• Provide effective loss control resources and solutions to clients
• Develop and maintain proactive service plans established with client’s support and buy-in
• Develop and conduct effective safety training programs using PowerPoint with multi-media
• Conduct Commercial and Industrial Property fire/safety inspections and effectively relating proper risk control measures (NFPA codes)

Senior Business Insurance Risk Control Consultant

• support Fidelity’s Issue Management Program, including issue monitoring and management
• prepare Executive-level reporting
• develop and implement risk analytics
• support various initiatives related to the Issue Management Program and Enterprise Risk Management Program
• assist with ensuring that there are prompt identification, escalation, and remediation of issues across all of Fidelity
• review issues to ensure they are reported accurately
• provide executive level summaries to senior leaders of issues when applicable
• produce executive and committee level reporting and presentations for the Heads of Risk

Manager, Corporate Risk – Issue Management

• Lead the enterprise development of the Risk Adjustment strategy and operation
• Set and execute a multi-year Risk Adjustment strategy for Medicare Advantage and ACA Marketplace
• Serve as the executive subject matter expert on Risk Adjustment performance, risk score accuracy, and revenue impacts
• Lead all Risk Adjustment functions, including Provider documentation and coding strategy
• Collaborate closely with Quality Management/STARS team, Medical Management, Population Health, and Clinical Informatics
• Lead, mentor, and develop a high-performing Risk Adjustment team, fostering accountability, innovation, and continuous learning.

See all jobs on JobTailor