Strategy Analyst V, Risk Adjustment- CDI Support

Strategy Analyst V, Risk Adjustment- CDI Support

Support Health Plan Risk Adjustment strategy through data analysis, performance monitoring, and business insights that drive operational excellence, compliance readiness, and program effectiveness. Analyze trends, identify risks and opportunities, evaluate process performance, and develop recommendations to improve risk capture accuracy, coding integrity, and regulatory compliance. Partner with operational, clinical, compliance, and leadership teams to support audit readiness, inform strategic decision-making, optimize program outcomes, and drive continuous improvement across Risk Adjustment initiatives.

Job Summary:

Drives strategy development by defining complex business problems and opportunities and identifying, weighing, and selecting alternative approaches. Performs moderately to highly complex analysis and drives interpretation of market data and tests hypotheses using advanced knowledge of qualitative and quantitative analytical tools to drive towards insightful and actionable insights for the business. Drives the development and execution of complex projects and programs to drive deliverables and effective execution to ensure high-quality business outcomes. Identifies opportunities to adapt processes to improve Return on Investment (ROI), service quality, and operations for cross-functional initiatives. Fosters strategic partnerships across organizational lines and establishes trusting relationships to better navigate the diverse and complex needs of key stakeholders.

Essential Responsibilities:

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Analyzes and interprets market data by: developing and implementing a plan to address complex research questions and test hypotheses with advanced knowledge in one or more specialty areas of data collection and analysis; driving moderately or to highly complex quantitative and qualitative analyses and investigating alternative hypotheses; and driving interpretation of key findings, conclusions, and recommendations for the future for senior leadership.
• Facilitates process improvement efforts by: identifying opportunities to adapt processes to improve return on investment (ROI), operations, service quality, and results for cross-functional initiatives; utilizing advanced knowledge of business operations to drive the implementation of best practices across functions; and facilitating adoption of best practices and future innovations.
• Effectively manages projects and programs by: driving the development of complex project proposals, including establishing objectives, key stakeholders, milestones, and providing deep technical leadership across programs; driving progress on program deliverables in alignment with greater business strategy and key business outcomes across functions; refining existing methodologies, and identifying and implementing new methodologies to complete initiatives with little support; and driving the execution of project plan, and supporting high-quality outcomes.
• Proactively maintains open streams of communication by: fostering trusting relationships to better navigate the diverse and complex needs of stakeholders across the organizational landscape; identifying complex issues or risks to strategic program implementation and developing solutions to resolve them; fostering strategic partnerships across organizational lines to consult and influence the development and refinement of key priorities and strategy; and proactively and persuasively communicating strategic issues and recommendations to senior leadership, and across the organization.
• Contributes to the development and execution of business strategy by: developing complex strategic plans based on business case and advanced knowledge in one or more specialty areas of health care marketplace; driving complex problem scoping and the processes and resources needed; developing alternative strategic options, and recommending the best option(s) based on complex problem scoping, external marketplace research, and analysis of organizational and external strategic approaches; selecting challenging business goals and the processes and resources needed to accomplish them; driving alignment around the strategic plan and intended outcomes, and finding opportunities for collaboration and synergy across functions; developing and implementing advanced strategies to mitigate complex barriers, constraints, and risks to execution; and driving strategic direction in response to a changing environment.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Applied Data Analysis
• Business Acumen
• Business Planning
• Business Process Improvement
• Business Relationship Management
• Business Strategy Leadership
• Financial Analysis
• Financial Market Research
• Market Knowledge
• Methodological Appropriateness
• Presentation Skills
• Project Management
• Risk Assessment
• Stress Tolerance
• Time Management

Minimum Qualifications:

• Minimum four (4) years of experience in project management, forecasting, planning, consulting, strategy development and/or execution, or a directly related field.
• Minimum two (2) years of experience in a leadership role with or without direct reports.
• Bachelors degree in Business, Health Care Administration, Public Health, Economics, Finance, or related field AND minimum seven (7) years of experience in strategic planning, strategy facilitation, execution of large-scope strategic projects or directly related field OR minimum ten (10) years of experience in strategic planning, strategy facilitation, execution of large-scope strategic projects or directly related field.

Preferred Qualifications:

• Two (2) years of experience working in a large matrixed organization.
• Two (2) years of Health Care experience.

Primary Location: California, Pasadena, Walnut Center - Regional Offices

Additional Locations:

• Fairfax, VA
• Pleasanton, CA
• Honolulu, HI
• Atlanta, GA
• Denver, CO
• Portland, OR
• Hyattsville, MD
• Renton, WA

Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Remote Employee Status: Regular Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Po/Ho Corp - 3YP Core - 0308 Pay Range: $156400 - $202290 / year