• Manager, Health Exchange Analytics

    Job Locations US-VA-Richmond
    Job ID
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
    If this sounds like you, read on!


    This position is primarily responsible for implementation and post-implementation program management of HHS Marketplace (HHS) program. This entails managing Finance, Reporting, and Analysis program implementation activities. Additionally, the HHS Marketplace Manager is responsible for managing the verification and analysis of financial information, quantitative analysis of various types of financial data, and leading all internal and external reporting for the program. This position will require expertise in the analysis of disparate data sources and development of data presentations to multiple operational areas within the company. This position will lead and participate in the analysis of business opportunities for new and existing lines of business.


    This role is also responsible for developing an extensive expertise in the HHS Risk Adjustment area: The manager will lead implementation of Prospective and Retrospective Assessments as well as associated vendor relationships. The manager will oversee building the processes that generate EDGE Server submissions from Annual Wellness Visits and Chart Reviews. Specific to the Chart Review process, the manager will interface with vendor to develop the extracts, facilitate transmission of extracts to vendor and coordinate analysis on chart yield.



    • Lead in the design, development and analysis of reports related to HHS lines of business as assigned
    • Lead the design and maintenance of data structures and systems for the HHS program
    • Lead in the design and development of the Data Report System, utilizing SQL and future set of software products and tools
    • Lead in development of benchmark reports
    • Utilize the DMAIC approach and utilize six sigma tools in order to improve operational efficiencies as needed
    • Support Director of Risk Programs in the development, presentation and execution of all HHS related initiatives as well as become a SME in HHS Risk Adjustment
    • Lead the development and submission of EDGE data to HHS
    • Develop processes to operationalize EDGE Return data into HCC yield and identify opportunities for feedback to internal and external stakeholders. Specifically, analyze EDGE returns to calculate risk scores, identify new HCCs and also errors and facilitating error resolution
    • Develop and present analytic outputs to senior management
    • Provide direct supervision of analysts. Coordinate the training and professional development of analysts, and facilitate their growth within the company
    • Oversee production of monthly HHS Deck. This entails production of Program portion of the deck and coordination with other Finance teams to incorporate their section into a joint cohesive deck
    • Facilitate creation and submission of all reports pertaining to the line of business
    • Facilitate operationalizing of all external/regulatory HHS program reports
    • Additional responsibilities as assigned by manager



    • Bachelor's degree in Business, Health Administration, Mathematics or Information Systems


    • Strong project management skills.
    • Strong analytical and prioritization skills with the ability to manage several projects simultaneously
    • Highly analytical thinking with demonstrated talent for identifying, scrutinizing, improving, and streamlining complex work processes
    • Must be able to perform under pressure and in a very dynamic environment
    • Have a high degree of initiative, motivation and passion for the business
    • Take ownership of projects and see them through to completion
    • Excellent interpersonal skills and strong strategic management skills
    • Work, direct, and take direction with all levels of management
    • Ability to understand complex processes and business structures
    • Perform in a diverse cross-functional team environment
    • Advanced personal computer skills, including experience with Microsoft Office
    • Performs complex data analysis using traditional and non-traditional statistical methods
    • Ability to analyze complex problems and develop multiple workable solutions
    • Demonstrates an active interest in enhancing current skills and learning new ones; applies advanced functional or technical knowledge to do his or her job at a high level of accomplishment
    • Chooses appropriate tools or technology for tasks; improves or redesigns processes, tools, or technologies to determine applicability
    • Highly skilled in writing queries that join multiple data sources and complex data manipulation
    • Consistently shares expertise with others, teaching skills and explaining concepts
    • Leads analytical team. May lead multi-functional teams
    • Coaches and mentors others
    • Demonstrated experience in troubleshooting complex problems
    • Organized, on-time, and displays energized attitude


    • Physical health sufficient to meet the ergonomic standards and demands of the position


    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE


    Our mission is to inspire healthy living within the communities we serve!


    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Need help finding the right job?

    We can recommend jobs specifically for you! Click here to get started.