Senior Insights Analyst (ACA Risk Adjustment)

Location: Remote-Flex in North Carolina and other states listed on the posting; virtual work with a few in-office visits each year. The position is associated with the Durham headquarters.

Salary: $98,092.00–$156,947.00 annually, plus an annual incentive bonus and benefits.

Company

hirify.global provides health insurance and supports health care delivery and community-focused programs.

What you will do

• Provide analytical ownership for ACA risk adjustment, including model implementation, testing, validation, and recurring member-level RAF score production.
• Collect, analyze, trend, forecast, and report complex healthcare data for internal and external stakeholders.
• Investigate variances and discrepancies across source systems, regulatory submissions, risk scores, transfer estimates, and provider settlement outputs.
• Reconcile analytical outputs, coordinate issue resolution, and improve controls, documentation, reporting, and repeatable processes.
• Use SQL, Python, and analytical platforms to build efficient data ingestion, validation, profiling, and report-generation processes.
• Present findings and recommendations, support vendors and cross-functional projects, and mentor less experienced employees while protecting health information.

Requirements

• Bachelor’s degree or advanced degree, where required, or 7+ years of related experience in lieu of a degree.
• 5+ years of experience in a related field.
• Experience analyzing, validating, documenting, and reporting complex data with high accuracy and recurring deadlines.
• Ability to communicate analytical findings, risks, and recommendations to technical and non-technical stakeholders.
• Ability to work remotely from North Carolina or another state listed on the posting, with a few in-office visits each year.

Nice to have

• Healthcare analytics experience, especially ACA commercial risk adjustment, HHS risk adjustment models, EDGE data or submissions, or regulatory analytics.
• Advanced SQL and Python experience for complex, repeatable data processes.
• Experience validating member-level risk scores, reconciling systems, and performing root-cause analysis.
• Experience supporting actuarial, finance, regulatory, operational, provider, or vendor stakeholders.
• Experience leading analytical work and coordinating cross-functional teams with limited supervision.

Culture & Benefits

• Remote-Flex work with flexibility, autonomy, and intentional in-person collaboration.
• Medical, dental, and vision coverage with health and wellness programs.
• Parental leave plus adoption and surrogacy assistance.
• Career development programs and tuition reimbursement.
• 401(k) match, annual company contribution, paid time off, and an annual incentive bonus.