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Principal Risk Adjustment & Revenue Integrity Analytics Lead at Lumeris - ApplyBlast

Principal Risk Adjustment & Revenue Integrity Analytics Lead

Lumeris

1 month ago

3.0 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

The Principal Risk Adjustment & Revenue Integrity Analytics Lead is a senior, hands-on analytics leader responsible for designing, building, validating, and operationalizing Medicare Advantage Part C risk adjustment analytics. This role serves as the analytic truth owner for Risk Adjustment, connecting risk-score performance, diagnosis capture, and revenue impact into a trusted operating model while partnering with executive leadership to align technical models with business strategy. The position requires translating complex data into actionable performance intelligence and driving proactive risk and revenue intelligence for the organization.

Responsibilities

Design and maintain risk adjustment analytics and reporting for Medicare Advantage plans
Develop risk-score and revenue forecasting models to analyze performance variances
Reconcile diagnosis-to-payment lifecycle and track recovery opportunities

Skills

About Lumeris

lumeris.com

Headquarters

Maryland Heights, Missouri, United States

Company Size

1001-5000 employees

Founded

2012

View Profile

Lumeris is a physician-founded, AI-powered healthcare transformation company dedicated to improving primary care through its AI-powered Primary Care as a Service platform, Tom™. The company partners with health systems, physician groups, and payers to deliver scalable, coordinated, value-based care that improves patient outcomes and financial performance. Lumeris serves over 1.2 million lives across commercial, Medicare, Medicaid, and value-based arrangements, leveraging 15+ years of healthcare transformation experience.