Risk Adjustment Financial Analytics Lead

Reposted 3 Days Ago
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Hiring Remotely in United States
Remote
107K-147K Annually
Senior level
Healthtech
The Role
The Risk Adjustment Financial Analytics Lead manages financial data to influence operational decisions, forecast revenue for the ESRD population, and analyze risk score models, collaborating with various business partners.
Summary Generated by Built In
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The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Location: remote however if local must be available to work in the office on Wednesdays

This role will lead the revenue and risk score forecasting of Humana’s End Stage Renal Disease (ESRD) population across bids, budget, and forecast cycles. Drive monthly current‑year forecasting, analyze membership and ESRD cohort mix changes, assess CMS model and policy impacts, and deliver early insights to leadership. In addition, this role will work closely with team members to solve complex problems through collaboration and supports business partners across the enterprise including Actuarial, Finance, and Operations.

Responsibilities

  • Lead end‑to‑end premium projections supporting Bids, Budget, and Quarterly Financial Forecast cycles.

  • Own monthly current‑year forecast processes, incorporating emerging experience and membership changes.

  • Monitor ESRD membership and mix changes, assessing downstream impacts on revenue and forecast accuracy.

  • Deliver early performance indicators to leadership highlighting emerging risks and opportunities.

  • Conduct actual‑versus‑expected analyses to identify variances, root causes, and opportunities for ongoing forecast and model improvements.

  • Maintain, enhance, and validate internal ESRD risk score engine models for risk adjustment valuations.

  • Analyze CMS ESRD risk model and policy changes, quantify financial impact, and communicate implications for bids, forecasts, and long‑term strategy.

  • Support the Individual Medicare Advantage (MA) team in bid development reviewing bid assumptions and validating plan‑level MA risk score projections.


Use your skills to make an impact
 

Role Essentials

  • Bachelors degree in business, finance, analytics, or any field

  • 6+ years finance, analytics, and/or healthcare or 7+ years total work experience

  • Proven experience developing and maintaining financial or analytical models

  • Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends

  • Explains variances and trends and enhances modeling techniques

  • SQL, SAS or other programing language

Role Desirables

  • Project or associate development leadership experience

  • Experience in Medicare Advantage Risk Adjustment or ESRD forecasting

Additional Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

  • Satellite, cellular and microwave connection can be used only if approved by leadership.

  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$106,900 - $147,000 per year


 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 05-07-2026
About us
 
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Top Skills

SAS
SQL
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The Company
Chicago, IL
40,741 Employees
Year Founded: 1961

What We Do

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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