Job Description This role is responsible for providing advanced analytical support for ACA risk adjustment, including data collection, model implementation, trending, forecasting, validation, reporting, and financial reconciliation. The Senior Insights Analyst will serve as a primary analytical resource for ACA risk adjustment activities, prepare and interpret complex data for internal and external customers, investigate discrepancies across data sources and systems, and translate findings into clear business insights. The role will partner closely with Actuarial, regulatory submission, value-based program, vendor, and operational stakeholders while helping improve analytical controls, documentation, automation, and recurring processes. Role Focus: Primary analytical ownership for ACA risk adjustment, including model implementation, RAF validation, regulatory analytics, financial reconciliation, discrepancy analysis, and stakeholder support. Job Description This role is responsible for providing advanced analytical support for ACA risk adjustment, including data collection, model implementation, trending, forecasting, validation, reporting, and financial reconciliation. The Senior Insights Analyst will serve as a primary analytical resource for ACA risk adjustment activities,



prepare and interpret complex data for internal and external customers, investigate discrepancies across data sources and systems, and translate findings into explicit business insights. The role will partner closely with Actuarial, regulatory submission, value-based program, vendor, and operational stakeholders while helping improve analytical controls, documentation, automation, and recurring processes. Role Focus: Primary analytical ownership for ACA risk adjustment, including model implementation, RAF validation, regulatory analytics, financial reconciliation, discrepancy analysis, and stakeholder support. What You’ll Do Use analytical and reporting tools, including SQL, Python, and other approved platforms, to efficiently access, investigate, validate, and analyze complex healthcare data. Develop, analyze, report, and interpret complex data for ongoing activities and projects while ensuring outputs are accurate, documented, and available within established deadlines. Support ACA risk adjustment model implementation, testing, validation, and recurring member-level RAF score production. Perform in-depth trend, variance, and root-cause analysis to explain changes in risk scores,

📌 Senior Insights Analyst (Raleigh)
🏢 Blue Cross NC
📍 Raleigh