CrawlJobs Logo

Manager, Risk Score Accuracy

healthfirst.org Logo

Healthfirst

Location Icon

Location:
United States , New York City

Category Icon
Category:
Finance

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

103400.00 - 149430.00 USD / Year
Save Job
Save Icon
Apply Position

Job Description:

Positioned in the Finance Department, the Manager, Risk Score Accuracy will be responsible for risk score accuracy through developing and managing forecasting models to support budgets and quarterly forecasts and interface with various departments across the organization to ensure appropriate explanations of any material variances to expectations.

Job Responsibility:

  • Develop and maintain risk score forecasting models to track, measure and trend performance for NYS PHSP products including Medicaid, Essential Plan, HARP, CHPlus and MLTC
  • Respond to requests for analysis and provide analytic support to the Product Managers, Actuarial department and Network/Hospital support
  • Manage and organize cross-departmental monthly meetings to discuss analysis requests, inform on the latest revenue trends, and to keep abreast of the changes occurring in our provider community
  • Keep abreast of New York Medicaid and CMS reforms and their impact on the health plan and sponsor hospital performance

Requirements:

  • Bachelor’s degree from an accredited institution
  • At least 5 years previous work experience within risk adjustment, grouper analysis or other statistical/clinical analysis
  • Experience with Medicaid/HHS risk adjustment payment methodologies
  • Proficiency in SQL (Script Development, Joins) – using PostgreSQL, MS SQL Server, MySQL and Advanced MS Excel Skills (Pivot Table Creation, Complex formula development)
  • Data Visualization Experience (Tableau or Qlik View or Power BI)
  • Experience in modeling the enterprise impact of risk/value-based revenue changes
  • Experience in supporting Product and Actuarial analytical requests
  • Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills
  • Strong project management experience and ability to handle multiple projects in a fast-paced environment

Nice to have:

  • At least 7 years previous work experience within risk adjustment, grouper analysis or other statistical/clinical analysis
  • Experience with NYS Medicaid risk adjustment payment methodologies and CRG models
  • Experience working with data obtained from UAS results for LTC products
  • Data Visualization Experience (Tableau or Qlik View or Power BI)
  • Python Scripting
  • Credentialed Associate of the Society of Actuaries (ASA)
  • Ability to effectively and efficiently adapt in a dynamic environment
  • Ability to challenge the status quo and drive lean implementation
  • Ability to quickly develop an understanding of systems and technology
  • Ability to effectively communicate with all levels of the organization, including senior leadership, technical staff, internal nontechnical staff, and business stakeholders
What we offer:
  • Medical, dental and vision coverage
  • Incentive and recognition programs
  • Life insurance
  • 401k contributions

Additional Information:

Job Posted:
December 09, 2025

Employment Type:
Fulltime
Work Type:
Hybrid work
Icon
Healthfirst - All Job Offers
Job Link Share:
Copy Link Icon
Facebook Icon Twitter Icon LinkedIn Icon

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Manager, Risk Score Accuracy

Counterparty Credit Risk Underwriter

The Counterparty Credit Underwriter supporting and working on coverage of a glob...
Location
Location
United Kingdom , London
Salary
Salary:
Not provided
https://www.citi.com/ Logo
Citi
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Good track record of experience in Hedge fund credit or related experience
  • Good knowledge of hedge fund/family office/private equity structures/operations and strategy types, prime brokerage and derivatives/capital market products, ISDA/other trading agreements, securities based lending (margin lending)
  • Strong grasp of current technologies including stress testing is highly beneficial
  • Knowledge of capital markets and securities based lending products
  • Strong analytical skills and ability to decompose transactions into the core risks
  • Good quantitative skills a plus
  • Solid Risk and Business judgment on the full spectrum of risk issues including Operational and Franchise Risk
  • University Degree/Graduate Degree in Business, Finance or Economics or equivalent is a plus
Job Responsibility
Job Responsibility
  • Implementing and applying the Credit Risk Framework for IFOs
  • Working closely with the IFO UW team lead to maintain and develop further the Wealth IFO governance framework, including the running and administration of regional IFO Forums, the stewardship of the Wealth IFO List, and the provision of advice as needed
  • Credit manage an assigned portfolio of IFOs globally
  • Lead, coordinate, or join due diligence (DD) meetings to understand the risk profile and dominant strategy of the IFOs and ensure risk appetite at the Citi level remains adequate
  • Assess key risks including portfolio concentration and diversification, liquidity, redemption risks if any
  • Assign Risk Ratings by using appropriate risk methodologies and scoring sheets
  • Assess risk rating methodology on a periodic basis
  • Decide client margin tiering and apply appropriate tiering guidelines and margins
  • Understand key risk dynamics and assessments at a fund/entity level as well as at the investment manager level
  • Understand the IFOs holding structure and investors base
What we offer
What we offer
  • Best-in-class benefits
  • Work-life balance
  • Fulltime
Read More
Arrow Right

Vice President of Engineering

Join a Series A–funded digital asset risk-management platform backed by Microsof...
Location
Location
United Kingdom
Salary
Salary:
140000.00 - 170000.00 GBP / Year
weareorbis.com Logo
Orbis Consultants
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Languages & Backend: Python, Go (Golang), TypeScript
  • Strong understanding of distributed systems, microservices, API-driven architectures
  • Data & Analytics: AWS Redshift, Athena, DynamoDB, Snowflake (or equivalent cloud data warehouses)
  • Kafka, Kinesis, or other streaming/event platforms
  • Experience building large-scale ingestion and normalisation pipelines
  • Experience with analytics engines, scoring frameworks, and real-time compute
  • Cloud & Infrastructure: AWS preferred (EKS, Lambda, S3, IAM, CloudWatch, ECS)
  • CI/CD tooling, infrastructure-as-code, observability, monitoring, deployment pipelines
  • Experience operating highly available systems in production environments
  • Security, Compliance & Enterprise: Secure systems design, identity/auth workflows, audit trails
Job Responsibility
Job Responsibility
  • Engineering Leadership & Execution: Lead engineering teams across backend, frontend, SRE, data platforms, and risk analytics
  • Drive execution of the engineering roadmap, delivering secure, scalable enterprise software
  • Define engineering processes that promote iteration, performance, and predictable delivery in a remote-first environment
  • Architecture & Platform Direction: Own end-to-end evolution of platform architecture: ingestion pipelines, scoring engines, real-time compute, APIs, and integrations
  • Guide system design decisions that ensure resilience, scale, and extensibility amid growing regulatory and market complexity
  • Lead technical direction for enterprise deployments, POCs, and customer integrations
  • Data Infrastructure & Analytics: Scale the data platform to support broader asset coverage, higher throughput, and more sophisticated analysis
  • Develop advanced analytics capabilities including anomaly detection, cross-chain signals, and automated scoring models
  • Ensure data accuracy, quality, and resiliency across pipelines and computation layers
  • Emerging AI & Automation Capabilities: Introduce new automation, reporting, and workflow intelligence features
What we offer
What we offer
  • Competitive salary + meaningful equity
  • Medical insurance (location dependent)
  • Fully remote + home office budget
  • Supported attendance at blockchain conferences
  • Opportunities to collaborate globally and shape emerging industry standards
  • Fulltime
Read More
Arrow Right

Product & Technical Go-To-Market Readiness Manager

The Product & Technical GTM Readiness Manager ensures all GTM teams can confiden...
Location
Location
Australia , Sydney; Melbourne; Hobart; Brisbane
Salary
Salary:
Not provided
https://www.upguard.com Logo
UpGuard
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 8+ years of progressive experience in Product or Technical Sales Enablement, Sales Engineering (SE), Technical Customer Success, or Product Marketing (PMM)
  • Deep exposure to Cybersecurity, GRC, Risk & Compliance, or DevOps environments
  • Proven track record working within a multi-product B2B SaaS organization, understanding the nuances of platform-based selling
  • Exceptional ability to distill complex technical concepts (architectures, integrations, workflows) into clear, structured, and sales-ready content
  • Strong presentation skills with the confidence to deliver training to both technical (SE/DevOps) and non-technical (Sales/CS) audiences
Job Responsibility
Job Responsibility
  • Curriculum Design: Build foundational and advanced product training for the full GTM team (AEs, SDRs, SEs, AMs, and CSMs), translating complex technical concepts (data flows, scoring logic, DORA compliance) into accessible, sales-ready narratives
  • Competency Frameworks: Define role-based product competency frameworks and oversee certification paths to ensure technical fluency across all regions and segments
  • Platform Storytelling: Own the technical 'UpGuard Platform' narrative, training teams on interoperability, cross-product workflows, and platform architecture to differentiate our market position
  • Demo Strategy: Own the demo structure across the unified platform
  • partner with SE leadership to maintain accuracy, depth, and effectiveness
  • POC Framework: Build a standard POC framework (success criteria, validation steps, best practices) and train reps on running efficient, high-quality technical evaluations
  • Skill Certification: Build and administer consistent certification programs for Demos and POCs to ensure AEs and SEs can deliver compelling, value-aligned technical presentations
  • Product Launches: Own the GTM readiness strategy for all product releases
  • partner with PMM (messaging) and Product (roadmap) to ensure consistent delivery of value propositions to the field
  • Launch Training: Execute role-based launch training and create internal readiness materials (walkthroughs, FAQs, demo updates) to drive immediate adoption of new features
What we offer
What we offer
  • Monthly Lifestyle subsidy: Use this for financial, physical, and mental well-being
  • WFH set-up allowance: To ensure you have the right environment to work in, we will help you get set up within your first 3 months at UpGuard
  • $1500 USD annual Learning & Development allowance: To support your career development, all team members will be able to expense development opportunities against this allowance
  • Annual leave: 6 weeks PTO plus two additional UpGuardian leave days to give you time to recharge your batteries
  • 18 weeks paid Parental Leave: Irrespective of parenting role
  • Personal Leave Allowance: This includes sick & carer’s leave
  • Fully remote working environment: While we have physical offices in Sydney & Hobart, we do not mandate compulsory attendance
  • Top-spec hardware: All team members will be provided with top-spec laptops for their role
  • Generative AI subsidy: UpGuard provides paid subscriptions for all team members to access generative AI tools to support their work
  • Fulltime
Read More
Arrow Right

Officer- Model Oversight & Model Maintenance- Business Planning Models

Model Maintenance and Oversight - overseeing model maintenance activities to ens...
Location
Location
India , Mumbai
Salary
Salary:
Not provided
https://www.citi.com/ Logo
Citi
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 6+ years of experience with good understanding of FP&A processes and management reporting
  • Professional degree equivalent to CA/MBA
  • Proficient in Microsoft Office with an emphasis on MS Excel
  • Knowledge with financial forecasting systems
  • Knowledge of Tableau, Knime and Python would be preferred
  • Experience of working with financial data and knowledge of financial reporting tools
  • Consistently demonstrates clear and concise written and verbal communication skills
  • Self-motivated and detail oriented
  • Demonstrated project management and organizational skills and capability to handle multiple projects at one time
Job Responsibility
Job Responsibility
  • Model Maintenance and Oversight - overseeing model maintenance activities to ensure compliance with Model Risk Management (MRM) guidelines and deadlines
  • Update inventory tracker for new models and changes in existing models
  • Monitor due dates and ensure alignment with model sponsors and MRM teams
  • Partner with FP&A teams to conduct Annual Model review and Ongoing Performance Assessments quarterly (high-risk models), semi-annually (medium-risk), and annually (low-risk)
  • Review the Ongoing monitoring results to identify potential model fatigue and preemptively remediate the issue by working with Model sponsors to ensure forecast accuracy
  • Support model documentation across model life cycle for various BAU and new model deliverables
  • Prepare and submit model documentation in approved MRM templates within iMRMS
  • Respond to MRM queries to ensure documentation approval by deadlines
  • Comply with various guidelines, timelines in relation to Models in coordination with various stakeholders and stay updated on any changes and additional requirement pertaining to above and comply on the same
  • Build strong relationships with stakeholders across MRM, FP&A, FTO, and Transformation teams
  • Fulltime
Read More
Arrow Right

Lead Data Scientist

We are looking to hire a Data Science Lead for our Product Algo360: Algo360 is a...
Location
Location
India
Salary
Salary:
Not provided
think360.ai Logo
Think360.ai
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • More than 5 years’ experience in working on data problems and 3+ years in credit risk modeling
  • Experience of team handling, and client management
  • Very high problem-solving skills
  • Strong mathematical, and modeling skills
  • Demonstrable experience of having created a huge impact on data analysis and statistical modeling
  • Proficient with Statistical modeling and understanding of association mining
  • Proficient and hands-on with R/Python/Ultrix
  • Working knowledge of query processing language and automation
Job Responsibility
Job Responsibility
  • Create data products and solutions which help millions of Indians in getting their credit needs met
  • Lead the charter of all analytical research and development activities for the product
  • Work with clients to identify opportunities to build insights that help clients accurately make decisions
  • Be the custodian of validating, approving and disproving hypotheses and business cases around new and existing data products
  • Enhance the existing credit risk score
  • Work towards improving the fill rates of key variables/insights
  • Use innovative techniques to create proxy variables that aid decision making for clients
  • Significantly contribute towards ideation, execution, go to market for the product roadmap development
  • Create and Maintain testing and accuracy monitoring framework to continuously Identify and debug outliers and anomalies
  • Create and maintain Data Sandbox to enable research and data mining for statistical modeling
Read More
Arrow Right

Vice President of Engineering

Join a Series A–funded digital asset risk-management platform backed by Microsof...
Location
Location
United Kingdom
Salary
Salary:
140000.00 - 170000.00 GBP / Year
weareorbis.com Logo
Orbis Consultants
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Deep hands-on architectural and technical leadership across distributed systems, data platforms, and analytics tooling
  • Languages & Backend: Python, Go (Golang), TypeScript
  • Strong understanding of distributed systems, microservices, API-driven architectures
  • Data & Analytics: AWS Redshift, Athena, DynamoDB, Snowflake (or equivalent cloud data warehouses)
  • Kafka, Kinesis, or other streaming/event platforms
  • Experience building large-scale ingestion and normalisation pipelines
  • Experience with analytics engines, scoring frameworks, and real-time compute
  • Cloud & Infrastructure: AWS preferred (EKS, Lambda, S3, IAM, CloudWatch, ECS)
  • CI/CD tooling, infrastructure-as-code, observability, monitoring, deployment pipelines
  • Experience operating highly available systems in production environments
Job Responsibility
Job Responsibility
  • Lead and scale the engineering organization responsible for delivering the company’s core risk platform
  • Define technical direction across architecture, data infrastructure, analytics systems, and compute pipelines
  • Integrate emerging intelligence-driven capabilities such as automated risk scoring, alerting, reporting, and anomaly detection
  • Work cross-functionally with Product, Analytics, and Customer Success
  • Engineering Leadership & Execution: Lead engineering teams across backend, frontend, SRE, data platforms, and risk analytics
  • Drive execution of the engineering roadmap, delivering secure, scalable enterprise software
  • Define engineering processes that promote iteration, performance, and predictable delivery in a remote-first environment
  • Architecture & Platform Direction: Own end-to-end evolution of platform architecture: ingestion pipelines, scoring engines, real-time compute, APIs, and integrations
  • Guide system design decisions that ensure resilience, scale, and extensibility amid growing regulatory and market complexity
  • Lead technical direction for enterprise deployments, POCs, and customer integrations
What we offer
What we offer
  • Competitive salary + meaningful equity
  • Medical insurance (location dependent)
  • Fully remote + home office budget
  • Supported attendance at blockchain conferences
  • Opportunities to collaborate globally and shape emerging industry standards
  • Fulltime
Read More
Arrow Right

Customer Success Operations Manager

We are looking for a hands-on, results-driven Customer Success Operations Manage...
Location
Location
United Kingdom; Netherlands , London; Amsterdam
Salary
Salary:
Not provided
corsearch.com Logo
Corsearch
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Hands-on experience administering Planhat (strongly preferred) or another CS platform e.g. Gainsight
  • Proven experience configuring backend integrations, data feeds, automations, and cross-system workflows
  • Experience supporting deployment of NPS/CSAT programs, including survey creation, workflow build & automation, feedback ingestion, data analysis and reporting
  • Strong analytical skills with a demonstrated ability to build action-oriented dashboards for the right stakeholders group, not just data visualisations
  • Demonstrated success in improving data accuracy and working across cross-functional teams
  • Strong project management skills: able to break down complex projects into manageable components and deliver successfully whilst keeping key stakeholders apprised of progress
  • Ability to work independently with minimal supervision while maintaining high standards and meeting deadlines
  • Excellent organisational skills, time management, attention to detail and a proactive problem-solving approach
  • Strong communication skills to articulate updates, risks, and progress to stakeholders
  • Ability to manage own workload, prioritise multiple initiatives and manage deadlines effectively
Job Responsibility
Job Responsibility
  • Serve as the primary system administrator for Planhat ensuring stability, accuracy, and usability across the CS organisation
  • Configure and maintain backend settings, including integrations, data feeds, custom fields, user roles, playbooks, workflows, and automations
  • Build and optimise dashboards that are actionable, insightful, and aligned to CS priorities (not data dumps but actionable insights)
  • Partner with cross-functional teams and other system admins to manage & improve systems integrations (e.g. SFDC, Qualtrics, Linear and Freshdesk) in a way that supports wider Corsearch needs
  • Support new feature rollouts, system enhancements, and troubleshoot issues for the CS organisation
  • Lead data-quality initiatives to ensure customer, account, and contact data incl key attribution is complete, reliable, and aligned across Planhat, Salesforce and other internal systems
  • Collaborate with cross-functional teams to resolve data gaps, streamline data flows and uphold consistent data standards
  • Monitor data health and establish processes to proactively maintain data integrity at scale
  • Support Sr. Director of CS Ops in operationalising the customer journey and delivering scalable, data-driven initiatives across key touchpoints
  • Build automations, workflows and rules of engagement that reduce manual work and improve consistency, eliminating dependency on spreadsheets
  • Fulltime
Read More
Arrow Right

Assessment Developer

The Assessment Developer (AD) is responsible for the development and maintenance...
Location
Location
United States of America , Raleigh, North Carolina
Salary
Salary:
64800.00 - 97200.00 USD / Year
edtechjobs.io Logo
EdTech Jobs
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in relevant disciplines or equivalent experience (master’s degree preferred)
  • 3+ years of assessment design and development experience
  • Ability to facilitate groups and meetings in person and remotely
  • Excellent written, oral, presentation, and interpersonal skills
  • Strong organizational skills, time management skills, and attention to detail
  • Ability to manage multiple projects effectively
  • Ability to manage schedules and commitments
  • Problem Solving Skills
  • Interpersonal Skills
  • Accuracy
Job Responsibility
Job Responsibility
  • Manages the design and development process for both objective and performance assessments, including milestones and timelines, and tracks progress
  • Communicates project status updates to cross-functional teams and stakeholders
  • Works with cross-functional teams to ensure projects have appropriate resources and realistic timelines and to solve any content-related issues regarding the assessments
  • Organizes and facilitates workshops for internal assessment development and review
  • Oversees subject matter expert involvement in the design, development, and review processes, as well as in the validation of an assessment’s congruency and accuracy
  • Maintains assessment design and development standards to ensure assessment integrity
  • Identifies and mitigates risks that may impact the quality or on-time delivery of assessments
  • Collaborates with the assessment team to define and execute assessment policies, processes, and best practices
  • Ensures alignment and consistency of assessments to WGU’s business objectives
  • Develops and implements item- and exam-level scoring guidelines and validates the successful implementation of these guidelines
What we offer
What we offer
  • bonuses
  • medical, dental, vision, telehealth and mental healthcare
  • health savings account and flexible spending account
  • basic and voluntary life insurance
  • disability coverage
  • accident, critical illness and hospital indemnity supplemental coverages
  • legal and identity theft coverage
  • retirement savings plan
  • wellbeing program
  • discounted WGU tuition
  • Fulltime
Read More
Arrow Right
Jobs by Category
Art and Entertainment Jobs Banking Jobs Call Center Jobs Construction Jobs Consulting Jobs Customer Service Jobs Education Jobs Energy Jobs Finance Jobs Gastronomy Jobs Health and Beauty Jobs Hospitality and Tourism Jobs Human Resources Jobs Insurance Jobs IT - Administration Jobs IT - Software Development Jobs Legal Jobs Logistics Jobs Manufacturing Jobs Marketing, Digital Marketing, SEO, SEM Jobs Media Jobs Nursing Jobs Office Administration Jobs Pharmacy Jobs Physical Work Jobs Public Relations Jobs Public Sector Jobs Purchasing Jobs Quality Control Jobs Real Estate Jobs Research and Development Jobs Sales Jobs
Job Positions Jobs by Country
United States Jobs United Kingdom Jobs India Jobs Canada Jobs Australia Jobs Germany Jobs Ireland Jobs Poland Jobs
Company
Blog About Us Contact
Follow Us
Facebook
X (Twitter)
LinkedIn
Instagram
CrawlJobs Group
ITFlashcards AllDevBlogs
© 2026 CrawlJobs Ltd. All Rights Reserved
Terms & Conditions Privacy Policy