Huron

3 weeks ago

CMS Edge Server / Risk Adjustment Data Architect

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 9 hours agoStatus: Live

Job Summary

Serve as a subject matter expert for CMS EDGE Server and ACA Risk Adjustment, partnering with healthcare payer clients to ensure accurate and compliant submission of membership, claims, encounter, and supplemental data to CMS. Lead CMS EDGE Server implementations, enhancements, and operational support, while driving data validation, reconciliation, and reporting quality improvements. Translate business requirements into product, process, and technical solutions and provide strategic advisory on CMS reporting best practices.

Location: Chicago

Workplace: Remote

Employment Type: Contract · 6 months

Job Function: Product Management

Seniority: Sr. Manager level

Key Responsibilities

•Serve as SME for CMS EDGE Server, ACA Risk Adjustment, and reinsurance programs.
•Lead CMS EDGE Server implementations, enhancements, and operational support initiatives.
•Ensure accurate and compliant submission of membership, claims, encounter, and supplemental data to CMS.
•Drive data validation, reconciliation, and reporting quality improvements.
•Partner with business, operational, compliance, and technical teams to resolve data and reporting issues.

Key Requirements

•7+ years of healthcare payer experience.
•Deep expertise with CMS EDGE Server and ACA Risk Adjustment.
•Strong understanding of reinsurance, risk adjustment, and regulatory reporting requirements.
•Experience with health plan membership, claims, and encounter data.
•Proven implementation and client-facing consulting experience.

Experience:7+ yearsHealthcare payerHealthcareRegulatory reportingACAMedicareMedicaid

Skills:CommunicationStakeholder managementProblem solvingRequirements translation

Tech Stack:CMS EDGE ServerSQLFacets (TriZetto)Cognizant CMS EDGE ServerClaimSphere

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Huron

Huron is a global professional services firm providing consulting and advisory services across healthcare, higher education, life sciences, and commercial sectors, focusing on strategy, operations, technology, and financial transformation.

Industry: Consulting

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: Chicago, United States

Founded: 2002

Glassdoor: 3.8

Website LinkedIn

Loading job details...

Preparing the role view and application actions.

Huron

3 weeks ago

CMS Edge Server / Risk Adjustment Data Architect

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 9 hours agoStatus: Live

Job Summary

Location: Chicago

Workplace: Remote

Employment Type: Contract · 6 months

Job Function: Product Management

Seniority: Sr. Manager level

Key Responsibilities

•Serve as SME for CMS EDGE Server, ACA Risk Adjustment, and reinsurance programs.
•Lead CMS EDGE Server implementations, enhancements, and operational support initiatives.
•Ensure accurate and compliant submission of membership, claims, encounter, and supplemental data to CMS.
•Drive data validation, reconciliation, and reporting quality improvements.
•Partner with business, operational, compliance, and technical teams to resolve data and reporting issues.

Key Requirements

•7+ years of healthcare payer experience.
•Deep expertise with CMS EDGE Server and ACA Risk Adjustment.
•Strong understanding of reinsurance, risk adjustment, and regulatory reporting requirements.
•Experience with health plan membership, claims, and encounter data.
•Proven implementation and client-facing consulting experience.

Experience:7+ yearsHealthcare payerHealthcareRegulatory reportingACAMedicareMedicaid

Skills:CommunicationStakeholder managementProblem solvingRequirements translation

Tech Stack:CMS EDGE ServerSQLFacets (TriZetto)Cognizant CMS EDGE ServerClaimSphere

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Huron

Industry: Consulting

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: Chicago, United States

Founded: 2002

Glassdoor: 3.8

Website LinkedIn