About this role

Analyze healthcare claims, pharmacy, lab, and Risk Adjustment submissions data to evaluate intervention and program performance.
Develop, maintain, and present reports that measure intervention ROI, incremental conditions captured, risk score impact, revenue impact, and other key Risk Adjustment performance metrics.
Partners with internal teams to support Risk Adjustment analytics needs, intervention planning, reporting enhancements, and issue resolution.
Stay current on healthcare analytics, Risk Adjustment trends, tools, methodologies, and regulatory considerations; recommend process or reporting improvements where appropriate.
Provide analytic solutions on ad-hoc requests with little oversight by senior analysts.

Bachelor’s degree or equivalent
3+ years’ experience in data or statistical analysis
Experience with managing and analyzing data for Government programs (Medicare Advantage, Commercial ACA)
Experience working with healthcare-related data, such as claims, encounters, provider data, CMS files, EDGE response files, or similar datasets.
Proficiency in SQL and data analytics.
Experience with Microsoft Azure DataBricks.
Advanced Excel skills.
Strong analytic skills to construct impactful findings from the extraction, manipulation and understanding of various types of data.
Successful experience working in a cross-functional environment.
Experience effectively communicating with stakeholder groups.

Risk Adjustment Data Analyst

Key skills