Senior Manager, Medicare Risk Adjustment Analytics

Job overview

The Senior Manager, Medicare Risk Adjustment Analytics role is onsite in Denver, CO. Compensation is $100,000–$120,000 per year. The role leads the Revenue Analytics team responsible for CMS risk adjustment analytics. The manager guides risk adjustment accuracy and revenue optimization through analysis of claims, encounter, and financial data. By ensuring compliant reporting, developing actionable insights, and presenting recommendations to senior leadership, the role supports strategic decisions and improved risk adjustment performance.

What you'll do

• Lead strategic planning for risk adjustment accuracy and revenue optimization
• develop reports on revenue financials and Medical Loss Ratio impact
• analyze clinical operations, claims, and encounter data using SQL
• ensure analytics comply with CMS regulations
• collaborate across clinical, finance, operations, legal, compliance, and IT
• maintain expertise in CMS-HCC models and policies
• manage and mentor direct reports
• present findings and recommendations
• contribute to process improvement.

What we're looking for

Skills & competencies

senior manager

medicare

risk adjustment analytics

cms-hcc

healthcare analytics

sql

medical claims

revenue optimization

medical loss ratio

denver co

macpower digital assets edge

$100k–$120k/year

Work arrangement

• Weekend coverage required

Why this role

Requires healthcare data and finance/analytics experience, risk adjustment program experience, SQL proficiency, and experience managing direct reports; bachelor's degree required and master's preferred.

About the employer

Macpower Digital Assets Edge Private Limited is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.