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  1. Home
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  5. Sr. Director, Risk Adjustment Data & Analytics
Alignment Health logo

Sr. Director, Risk Adjustment Data & Analytics

Not Disclosed•Full-TimeRemote

location_onRemote

Apply Now

About Alignment Health

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

About the Role

The Sr. Director, Risk Adjustment Data & Analytics is a senior technical and operational leader responsible for advancing the integrity, completeness, and strategic value of Medicare Risk Adjustment (MRA) data and analytics programs within the organization. This role serves as the primary accountable leader for MRA data operations, owning the analytical and data engineering infrastructure that enables suspecting, chart review, coding, submission, and reconciliation workflows to operate at scale.

Working cross-functionally with MRA Business leadership, Finance, Actuarial, Clinical Operations, Compliance, and enterprise IT teams, this leader ensures that all key stakeholders are working from consistent, trusted, and defensible MRA data. The role leads a multidisciplinary team of analysts, data scientists, and data engineers, setting analytical standards and translating program outcomes into clear, actionable insights for senior leadership.

This role is critical to the organization because Risk Adjustment Factor (RAF) scores directly drive plan revenue, making accurate, timely, and defensible MRA data a high-stakes organizational priority. As the operational owner of this capability, you will drive the culture of quality and continuous improvement necessary to navigate a highly regulated environment.

Equal Opportunity

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

Important Security Notice

Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam, please report the incident to the Federal Trade Commission. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com.

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Skills, education and keywords

Skills: Medicare Risk Adjustment, HCC Coding, Icd-10 Coding, Raf Score Calculation, CMS Encounter Data Submission, Radv Audit, Data Analytics, Statistical Modeling, Power Bi, Tableau.

Education: Bachelor's degree in quantitative field or equivalent combination of education, certification, and experience; Master's degree in Data Science, Health Informatics, Biostatistics, or related field.

Frequently asked questions about Sr. Director, Risk Adjustment Data & Analytics at Alignment Health

What does a Sr. Director, Risk Adjustment Data & Analytics at Alignment Health do?expand_more
In this Sr. Director, Risk Adjustment Data & Analytics at Alignment Health role, you will lead end-to-end mra data operations including ingestion, transformation, validation, and reporting; develop analytical frameworks to translate risk score trends into executive-ready narratives; establish data governance standards to ensure audit readiness and regulatory compliance; and direct and develop a multidisciplinary team of analysts, data scientists, and engineers.
What are the requirements for this Sr. Director, Risk Adjustment Data & Analytics role?expand_more
To qualify for the Sr. Director, Risk Adjustment Data & Analytics at Alignment Health position, applicants should have: 7–10 years healthcare data/analytics experience with Medicare Advantage Risk Adjustment; Bachelor's degree in Health Informatics, Data Science, Statistics, CS, Math, Healthcare Admin, or related field; Advanced Medicare Risk Adjustment (MRA) operations expertise (HCC, ICD-10, RAF, RADV); Advanced SQL and data querying skills; Proficiency in Power BI, Tableau, or equivalent BI platforms; and Advanced Excel or Google Sheets modeling.

Work location

Work model: Remote

location_on

Remote

Key Responsibilities

  • check_circleLead end-to-end MRA data operations including ingestion, transformation, validation, and reporting
  • check_circleDevelop analytical frameworks to translate risk score trends into executive-ready narratives
  • check_circleEstablish data governance standards to ensure audit readiness and regulatory compliance
  • check_circleDirect and develop a multidisciplinary team of analysts, data scientists, and engineers
  • check_circleIdentify data quality gaps and drive corrective actions through process redesign and tooling
  • check_circlePartner with Finance and Actuarial teams to clarify revenue impacts and variance drivers

Requirements

  • verified7–10 years healthcare data/analytics experience with Medicare Advantage Risk Adjustment
  • verifiedBachelor's degree in Health Informatics, Data Science, Statistics, CS, Math, Healthcare Admin, or related field
  • verifiedAdvanced Medicare Risk Adjustment (MRA) operations expertise (HCC, ICD-10, RAF, RADV)
  • verifiedAdvanced SQL and data querying skills
  • verifiedProficiency in Power BI, Tableau, or equivalent BI platforms
  • verifiedAdvanced Excel or Google Sheets modeling
  • verifiedFamiliarity with cloud data environments (Azure, AWS, GCP)

Nice to Have

Experience building or scaling data and analytics functions within a health plan or insurance organization. Experience working with chart retrieval vendors and provider partners to coordinate medical records access. Experience implementing coding and auditing platforms (e.g., Episource, Veradigm, Cotiviti). Master's degree in Data Science, Health Informatics, Biostatistics, or a related field. Formal training in data governance frameworks, audit readiness methodologies, or advanced analytics (e.g., DAMA, CDMP, or equivalent). Training in Medicare Advantage regulations, CMS reporting requirements (encounter data, RADV, HEDIS, STAR ratings, interoperability), and general health plan operations. Familiarity with Python or R. Certified Risk Adjustment Coder (CRC) issued by AAPC, or Certified Professional Coder (CPC); or relevant data science/analytics certifications (e.g., CDMP, Databricks, Microsoft Azure Data Fundamentals).

Alignment Health cover image
Alignment Health logo
Company

Alignment Health

Industry

Hospitals and Health Care

Headquarters

Orange, CA

Open Roles

2

Alignment Health operates within the Hospitals and Health Care industry, with its headquarters located in Orange, California. The organization focuses on transforming health care delivery by prioritizing patient well-being over traditional payment structures. Its approach involves identifying and eliminating systemic inefficiencies to align the goals of patients, providers, and payers toward improved wellness outcomes. By leveraging data-management technology and practices derived from Medicare Advantage, the company serves seniors, the chronically ill, and frail individuals who require specialized attention. The company provides partners and patients with customized care and service tailored to specific needs, whether in clinical coordination, risk management, or technology facilitation. Alignment Health offers health plan options directly through Alignment Health Plan while also collaborating with select health plans to deliver enhanced benefits at reduced costs. This model aims to lower expenses while simultaneously improving the quality of life for those it serves. For additional details regarding its services and offerings, the organization directs inquiries to its official website at www.alignmenthealthcare.com.
View company profilearrow_forwardlanguageWebsitelinkLinkedIn
Quick Overview

Experience

7-10 yrs (Lead)

Education

Bachelor's degree in quantitative field or equivalent combination of education, certification, and experience

Job Type

Full-Time

Skills Required

Medicare Risk AdjustmentHCC CodingIcd-10 CodingRaf Score CalculationCMS Encounter Data SubmissionRadv Audit
arrow_forward
Where is the Sr. Director, Risk Adjustment Data & Analytics role at Alignment Health located?
expand_more
Sr. Director, Risk Adjustment Data & Analytics at Alignment Health is based in Remote. This is a remote role.
Is this Sr. Director, Risk Adjustment Data & Analytics job remote, hybrid, or on-site?expand_more
Alignment Health has listed this Sr. Director, Risk Adjustment Data & Analytics role as remote.
How much experience is required for this Sr. Director, Risk Adjustment Data & Analytics role?expand_more
Sr. Director, Risk Adjustment Data & Analytics at Alignment Health typically requires 7–10 years of relevant experience at the lead level.
What skills do you need for the Sr. Director, Risk Adjustment Data & Analytics role at Alignment Health?expand_more
Key skills for Sr. Director, Risk Adjustment Data & Analytics at Alignment Health include Medicare Risk Adjustment; HCC Coding; Icd-10 Coding; Raf Score Calculation; CMS Encounter Data Submission; Radv Audit; Data Analytics; and Statistical Modeling.
What education is required for Sr. Director, Risk Adjustment Data & Analytics at Alignment Health?expand_more
Educational requirements for this role: Bachelor's degree in quantitative field or equivalent combination of education, certification, and experience; and Master's degree in Data Science, Health Informatics, Biostatistics, or related field.
What category does the Sr. Director, Risk Adjustment Data & Analytics role belong to?expand_more
Sr. Director, Risk Adjustment Data & Analytics at Alignment Health is part of the it job category on Recrutus.

About Alignment Health

Alignment Health operates within the Hospitals and Health Care industry, with its headquarters located in Orange, California. The organization focuses on transforming health care delivery by prioritizing patient well-being over traditional payment structures. Its approach involves identifying and eliminating systemic inefficiencies to align the goals of patients, providers, and payers toward improved wellness outcomes. By leveraging data-management technology and practices derived from Medicare Advantage, the company serves seniors, the chronically ill, and frail individuals who require specialized attention.

The company provides partners and patients with customized care and service tailored to specific needs, whether in clinical coordination, risk management, or technology facilitation. Alignment Health offers health plan options directly through Alignment Health Plan while also collaborating with select health plans to deliver enhanced benefits at reduced costs. This model aims to lower expenses while simultaneously improving the quality of life for those it serves. For additional details regarding its services and offerings, the organization directs inquiries to its official website at www.alignmenthealthcare.com.

Browse more roles: All Alignment Health jobs, it jobs on Recrutus.

Recrutus

Curating the world's most innovative career opportunities. We bridge the gap between visionary talent and industry-leading companies.

Search roles by city, category, skill, or job type — explore verified employers, salary benchmarks, and remote-friendly teams across India and beyond.

publiclanguageshare
Job seekers
Browse jobsCompanies hiringRemote jobsJobs by locationJobs by cityJobs by categoryCareer guidesCareer blogSalary insights
Job types
Contractor jobsFull-Time jobsIntern jobsOther jobsPart-Time jobsPer-Diem jobsTemporary jobs
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Jobs in TexasJobs in New YorkJobs in CaliforniaJobs in FloridaJobs in TennesseeJobs in VirginiaAll states →
Top categories
Healthcare & Nursing jobsLogistics & Warehouse jobsEngineering jobsAccounting & Finance jobsSales jobsIT jobsHospitality & Catering jobs
Popular skills
CDL-A jobsRegistered Nurse jobsBLS jobsExcel jobs
Featured employers
Company
About usFAQContactPrivacy policyUS privacy notice

Recrutus helps candidates discover roles that match their skills and helps teams reach qualified applicants faster. Browse by metro, discipline, or work style — from internships to senior leadership.

© 2026 Recrutus. All rights reserved.
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Data Analytics
Statistical Modeling
Power Bi
Tableau
Accessibility