Informatics Manager – Risk Adjustment

CVS Health Careers

. Support vendor management teams and regional stakeholders with vendor strategy, selection, contracting, onboarding, performance management, and issue resolution for Medicare and Medicaid risk adjustment programs .

Posted 11/6/2026full-timeHartford • Connecticut • United StatesMid-LevelSenior💰 $60,300 - $145,860 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in vendor management and healthcare analytics, with a strong focus on Medicare and Medicaid risk adjustment programs. Proficient in data analysis, performance measurement, and the use of business intelligence tools to enhance operational efficiency and decision-making.

Highest-signal resume keywords

Healthcare AnalyticsVendor ManagementSQL Data AnalysisBusiness Intelligence ReportingRisk Adjustment Programs

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisFinancial AnalysisPerformance MeasurementValuation MethodologiesContract Performance MeasuresSensitivity AnalysesReturn-On-Investment AssessmentsVendor ScorecardsGoverned AnalyticsAI-Enabled Capabilities

Soft Skills

Problem-SolvingDecision-MakingCollaborationStakeholder ManagementPlanning

Tools & Technologies

SQLPythonAmazon QuickTableauPower BIAmazon Web ServicesGoogle Cloud PlatformDatabricks

Certifications & Qualifications

Bachelor's DegreeSpecialized TrainingRelevant Professional Qualification

Industry Keywords

Medicare AdvantageMedicare Part DMedicaidRisk AdjustmentVendor Performance Management

Tech Stack

Tools & technologies

AWSCloudGoogle Cloud PlatformPythonSQLTableau

About the role

Key responsibilities & impact

Support vendor management teams and regional stakeholders with vendor strategy, selection, contracting, onboarding, performance management, and issue resolution for Medicare and Medicaid risk adjustment programs
Develop and maintain vendor valuation methodologies quantifying financial opportunity, return on investment, operational impact, and performance against contractual commitments
Evaluate vendor capabilities, data quality, coding accuracy, submission readiness, scalability, and alignment with enterprise risk adjustment objectives
Establish scorecards, key performance indicators, and governance routines to monitor vendor performance
Use technology and programming skills to oversee data, reporting, and analytics for assessing risk adjustment performance, forecasting revenue impact, reconciling results, and identifying opportunities or risks
Translate Medicare and Medicaid risk adjustment requirements into business, data, and technology specifications for internal teams and external vendors
Develop, maintain, and execute analytics and AI-enabled capabilities improving vendor oversight, valuation accuracy, operational efficiency, and decision-making
Design and maintain documentation for vendor processes, data flows, and valuation models
Present vendor performance, valuation findings, recommendations, and escalation items to senior leaders and governance forums

Requirements

What you’ll need

3+ years of relevant experience in healthcare analytics, risk adjustment, vendor management, financial analysis, or an equivalent combination of experience
Working knowledge of Medicare Advantage, Medicare Part D, Medicaid, and state-specific risk adjustment programs
2+ years of experience with SQL and/or Python for data analysis, validation, reconciliation, and performance measurement
2+ years of experience with business intelligence reporting tools such as Amazon Quick, Tableau, or Power BI
Strong problem-solving, decision-making, planning, execution, collaboration, and stakeholder management skills
Preferred: experience with Medicare Advantage, Part D, Medicaid, or state risk adjustment models, data submissions, reconciliation, and revenue forecasting
Preferred: experience evaluating and managing risk adjustment vendor performance
Preferred: experience developing vendor valuations, financial forecasts, sensitivity analyses, and return-on-investment assessments
Preferred: experience with contract performance measures, procurement processes, vendor scorecards, and executive governance
Preferred: experience using governed analytics or AI-enabled capabilities to improve risk adjustment operations, valuation, or vendor oversight
Preferred: experience with cloud platforms such as Amazon Web Services (AWS) and Google Cloud Platform (GCP)
Preferred: experience working with Databricks to query data, develop analysis, and deploy dashboards
Bachelor's degree preferred/specialized training/relevant professional qualification

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay