Use your SQL, analytics, and risk adjustment expertise to drive strategy instead of just reporting on it. This fully remote role lets you shape how a fast-growing value-based care organization understands risk, revenue, and member health.
About Curana Health
Curana Health is on a mission to radically improve the health, happiness, and dignity of older adults. As a national leader in value-based care, Curana partners with senior living communities and skilled nursing facilities through on-site primary care, Accountable Care Organizations, and Medicare Advantage Special Needs Plans. Since 2021, they’ve grown quickly, now serving 200,000+ seniors across 1,500+ communities in 32 states with a multidisciplinary team of clinicians, analysts, operators, and support staff.
Schedule
- Position Type: Full-time, remote
- Location: US-based, work-from-home environment
- Department: Risk Adjustment / Analytics
- Work Style: Cross-functional collaboration with internal teams, plan partners, and vendors
- Work Authorization: Must be authorized to work in the United States (no visa sponsorship available)
What You’ll Do
- Lead delegated and ad hoc analyses related to risk adjustment, from data exploration through recommendations.
- Recommend and guide process improvements that increase accurate risk capture while minimizing incorrect disease burden.
- Identify, analyze, interpret, and communicate risk adjustment trends through reports and presentations to provider partners and internal stakeholders.
- Maintain and build reports and dashboards that support company goals, along with one-off analytics requests as needed.
- Develop and maintain data sets using internal data, CMS response files (MMR, MOR, RAPS, EDPS, MAO-002, MAO-004, etc.), and other sources for enterprise-wide use.
- Maintain strict oversight of vendors and plan partners through analytical reconciliations to ensure regulatory compliance and accurate submissions.
- Support audits, including RADV, by preparing documentation and performing analytical reviews.
- Perform root cause analyses to identify and correct discrepancies or gaps in data and processes.
- Stay current on CMS regulations, announcements, and risk model changes, and translate those changes into actionable insights.
- Build and report on actionable risk adjustment metrics, incorporating quality and health outcome measures where appropriate.
- Support financial projections tied to risk adjustment, including receivables, pricing, and cost utilization.
- Work with changing file specs and data structures, coordinating releases and modifications through approved procedures.
- Collaborate with internal teams and external partners to resolve data issues related to members, claims, providers, and pharmacy.
What You Need
- Bachelor’s degree (BA/BS) required.
- 5+ years of risk adjustment experience within healthcare or a risk-adjustment-focused vendor.
- Familiarity with value-based care models (ACOs, Medicare Advantage, etc.) preferred.
- AAPC or AHIMA coding certification is a plus.
- Strong analytical mindset with the ability to dissect problems, form hypotheses, and recommend data-backed solutions.
- Proven ability to explain complex ideas and processes in a clear, simple way to both technical and non-technical audiences.
- High technical acumen with strong proficiency in Excel and SQL; PowerBI and/or PTT experience preferred but not required.
- Experience creating executive-facing reports, decks, or other decision-support deliverables.
- Comfortable working in a fast-paced, evolving environment with a high degree of autonomy and collaboration.
Benefits
- Fully remote role with the ability to drive strategy and decision-making, not just pull reports.
- Direct impact on how a rapidly growing, mission-driven organization understands and manages risk for senior populations.
- Opportunity to work with diverse data sources, risk models, and cross-functional teams to grow your technical and strategic skill set.
- Join a company recognized as one of the fastest-growing private healthcare organizations in the country, with room to advance your analytics career.
If you’re ready to move beyond basic reporting and become a strategic partner in risk adjustment, this role is a strong next step.
Turn your analytics into real-world impact for seniors and the teams who care for them.
Happy Hunting,
~Two Chicks…