Lead Director, Risk Adjustment Performance Reporting and Insights

What you'll do

• Develop and deliver enterprise risk adjustment analytics and business intelligence solutions using clinical and operational data.
• Create actionable insights through data storytelling, advanced visualizations, and AI-driven automation to support executive decision-making.
• Report on risk adjustment KPIs and performance drivers at the market, plan, and provider levels via dashboards.
• Analyze provider performance metrics to identify trends, gaps in care, and opportunities for targeted intervention strategies.
• Lead the adoption of predictive analytics, automated reporting tools, and modern business intelligence capabilities across the organization.
• Partner with cross-functional leaders in Finance, Clinical, and IT to establish governance standards and scalable data solutions.
• Manage, mentor, and develop a high-performing team of analytics and business intelligence professionals.
• Provide technical guidance to staff on BI tool input modeling, calculations, and coding processes.

What we're looking for

• 10+ years of experience in healthcare analytics, informatics, performance insights, actuarial, value-based, or business intelligence.
• 2+ years of leadership experience managing analytics, reporting, or business intelligence teams.
• Strong executive communication, strategic thinking, stakeholder management, and team development skills.
• Advanced experience with programming languages such as SQL or Python and BI platforms like Power BI, Tableau, or QuickSight.
• Proven ability to lead complex analytics portfolios and maintain organization in developer code and processes.
• Knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims/clinical data, and CMS requirements (preferred).
• Experience at a health plan or provider system (preferred).
• Master's degree in a relevant field or equivalent professional certification and expertise (preferred).