Risk Adjustment Data Analyst - Remote

Overview

The Risk Adjustment Data Analyst will play a key role in managing and analyzing healthcare data to support accurate risk adjustment calculations and forecasting for Medicare populations.

In Short

• Calculate and maintain risk scores for Medicare members using CMS HCC risk adjustment models.
• Develop SQL processes to automate risk score calculations.
• Analyze project performance and identify value drivers for risk adjustment initiatives.
• Create and automate KPIs specific to risk adjustment.
• Collaborate with Actuarial, Health Economics, and Finance teams.
• Build dashboards and automated reporting in Tableau.
• Provide data and reporting support for practice and provider scorecards.
• Ensure adherence to CMS HCC risk adjustment guidelines.
• Develop automated processes and maintain risk adjustment models.
• Perform additional responsibilities as assigned.

Requirements

• Strong technical skills in SQL, data visualization, and analytics.
• Ability to translate complex datasets into clear reports and dashboards.
• Experience in healthcare data analysis.
• Understanding of CMS HCC risk adjustment guidelines.
• Collaboration skills to work with cross-functional teams.

Benefits

• Collaborative work environment.
• Impact on the quality and accuracy of healthcare analytics.