Manager, Reporting and Analytics – Medicare Advantage

Location: Canton, MA

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions.

We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Reporting to the Director of Risk Adjustment Reporting and Analytics, the Manager of Reporting and Analytics – Medicare Advantage will apply a blend of advanced business, analytical, technical, and leadership skills to ensure the accuracy, completeness, and integrity of risk adjustment data submissions to CMS. This role will optimize risk score accuracy, support revenue performance across all Medicare Advantage products, and ensure the timely, accurate, and compliant submission and reporting of All-Payer Claims Database (APCD) files to six state agencies.

This individual will synthesize large data sets, complex information and work effectively across business areas including Member Operations, Provider Information, Claims, Information Technology (IT) and Actuarial. The Manager will possess a strong understanding of data architecture, data lineage, and relational databases and will actively partner with IT teams on solution design, data flow analysis, root-cause investigations, implementation planning, and quality assurance of IT deliverables.

The Manager will lead a team of 3-4 senior analysts and data leads, providing coaching, mentorship, performance management, and professional development to build a highly engaged and high-performing team. In addition, the Manager will oversee all EDS/EDPS submissions for Point32Health and serve as the organization's subject matter expert for Medicare Advantage Encounter Data Processing System (EDS/EDPS) submissions and APCD reporting.

Key Responsibilities/Duties – what you will be doing (top five):