Risk

• Lead the development and execution of business analysis, technology strategy, and solutions governance initiatives supporting Private Markets Investment Management priorities
• Partner with senior leaders across Operations, Investment Management, Finance, Technology, and Data to align technology investments, process improvements, and delivery priorities with business objectives
• Provide strategic ownership and oversight of platforms supporting the private markets investment lifecycle, including investment operations, fund accounting, portfolio management, investor servicing, reporting, and data management
• Establish governance processes to assess, prioritize, and manage projects, enhancements, resource allocation, risks, dependencies, and business outcomes
• Drive operational transformation through process optimization, automation, analytics, AI-enabled solutions, and improved user experience
• Lead, coach, and develop a team of Business Analysts

Director, Business Analysis – Solutions Governance

• Perform accurate and timely reviews and validations of Medicare, Medicaid, Commercial HCCs, and DxCGs through medical record reviews
• Review provider documentation and verify ICD-10-CM coding against coding standards and CMS and Commercial Risk Adjustment guidelines
• Evaluate HCC/DxCG coding practices and provide analyses and recommendations to improve provider documentation
• Review medical records to verify ICD-10-CM and CPT codes accurately reflect provider documentation
• Summarize audit findings for internal and external parties and provide provider education
• Audit medical records for LCO groups and network providers to ensure diagnosis and CPT coding accuracy
• Evaluate records for authorized providers, face-to-face CPT codes, signatures, and other technical requirements
• Track audit results, identify trends, and recommend corrective actions
• Collaborate with leadership, staff, and vendors to identify and submit coding adjustments
• Provide education and feedback to physicians and network providers on risk adjustment and coding guidelines
• Interpret coding guidelines and CMS regulations for leadership
• Research and resolve coding and risk adjustment regulatory issues
• Work retrospective/concurrent audit reports to close diagnosis gaps
• Perform pre-visit chart reviews and provider outreach
• Present recommendations and coding issue findings to key internal staff and leadership

Risk Adjustment Consultant

• Perform sophisticated risk analyses using Verisk's technology for insurers, brokers, reinsurers and other financial intermediaries
• Respond to client questions and resolve issues collaboratively with internal teams
• Design and deliver client training across the company's solutions
• Perform risk analyses for consulting projects, client support, and internal initiatives
• Develop project timelines and manage deliverable expectations with clients
• Apply project management best practices to consulting studies and mid- to large-scale projects
• Develop client relationships, understand workflows and objectives, and provide proactive service
• Lead onboarding efforts for new clients, including training, workflow design, model-result interpretation, and adoption support
• Collaborate with business development and senior management on client-specific performance objectives
• Support model and product change management
• Provide product-development feedback and engage through feature design, development, and release
• Support technical and presales sales efforts
• Represent Verisk at conferences, industry events, media opportunities, and meetings
• Serve as an ambassador of Verisk to clients and prospects

Risk Analyst

• Deliver high-level client service through positive interactions with clients in multiple industries, CLA staff, and external entities
• Demonstrate awareness and understanding of clients’ technical environments and business processes
• Review controls relevant to businesses, networks, security devices, servers, and end-user computing devices
• Document supporting audit evidence in alignment with firm standards
• Identify key risks and mitigating controls
• Communicate project status and issues requiring immediate attention to appropriate team members

Business Risk Intern

• Develop, maintain, and assess Shift’s integrated security and privacy management framework
• Manage compliance with key industry standards
• Lead risk assessments
• Oversee the third-party security assurance program
• Support TrustOps efforts for customer collateral, questions, contract reviews, and due diligence
• Translate global information security expectations into actionable policies, standards, and procedures
• Promote security and compliance across the organization and act as a subject matter expert
• Support the security awareness program
• Develop and maintain privacy policies, data handling standards, and public-facing privacy notices
• Develop and maintain the security assurance plan and evaluate security controls
• Improve third-party information security assurance and continuous assessment processes
• Identify risk areas and facilitate security control evaluations and testing
• Review architectural designs and new initiatives for security alignment and risk mitigation
• Support and facilitate Data Protection Impact Assessments
• Manage and coordinate ISO 27001 and SOC 2 Type II internal and external audits
• Analyze and compile compliance documentation and evidence
• Coordinate remediation of audit findings and track them to closure
• Support responses to Data Subject Access Requests
• Communicate with third parties and suppliers to conduct risk assessments, review security posture, and manage issue remediation
• Report to the GRC Lead within the Information Security department

Senior GRC Analyst

• Establish a shared vision across the company for a portfolio of products or platform products enabling development and scalability
• Lead product strategy development with cross-functional stakeholders
• Shape the architectural roadmap while balancing innovation, technical implementation, regulatory requirements, time-to-market, customer needs, and profitability
• Champion customer experience and prioritize customer needs in product requirements and decision-making
• Define and use product success metrics, usability studies, research, and market analysis
• Standardize analytics, customer discovery, market research, and competitive analysis workstreams
• Manage product portfolio profitability, including budgetary decisions
• Lead Product Reviews, Operating Reviews, and Business Reviews to drive execution and accountability
• Interface with senior leadership as needed
• Maximize efficiency in a constantly evolving environment

Risk jobs in Massachusetts

Director, Business Analysis – Solutions Governance

Risk Adjustment Consultant

Risk Analyst

Business Risk Intern

Senior GRC Analyst

Senior Director, Global Risk, Servicing, Comms Platform