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University Health in the United States is seeking a Risk Adjustment Data Analyst to support CMS risk adjustment program by analyzing healthcare data, retrieving medical records, and monitoring HCC capture. You will collaborate with internal teams and vendors to ensure accurate reporting and regulatory compliance.
The role requires a bachelor’s degree in a related field, at least two years of healthcare data analysis experience, and proficiency with Excel.
University Health is a leading healthcare organization dedicated to providing comprehensive and innovative medical services to diverse communities. With a strong commitment to excellence, patient-centered care, and continuous improvement, University Health strives to enhance health outcomes through advanced clinical practices, cutting-edge technology, and a dedicated team of healthcare professionals. The organization values integrity, collaboration, and a passion for making a positive impact on the lives of its patients and communities it serves.
University Health is a leading healthcare organization dedicated to providing comprehensive and innovative medical services to diverse communities. With a strong commitment to excellence, patient-centered care, and continuous improvement, University Health strives to enhance health outcomes through advanced clinical practices, cutting-edge technology, and a dedicated team of healthcare professionals. The organization values integrity, collaboration, and a passion for making a positive impact on the lives of its patients and communities it serves.
The Risk Adjustment Data Analyst at University Health plays a vital role in supporting the organization’s Risk Adjustment program. This position involves analyzing healthcare data, generating detailed reports, retrieving medical records, and monitoring performance metrics to ensure optimal risk adjustment outcomes. The analyst will collaborate closely with internal departments, provider networks, and external vendors to facilitate accurate and timely collection and analysis of risk adjustment data. Utilizing health informatics and analytics tools, the analyst will identify trends, track key performance indicators, and support Hierarchical Condition Category (HCC) capture initiatives. The role also encompasses assisting with medical record retrieval efforts, data validation, provider performance analysis, and ensuring compliance with CMS and other regulatory standards. This position is essential in helping University Health optimize risk adjustment processes, improve data accuracy, and support organizational compliance and financial sustainability.
The ideal candidate will possess a Bachelor’s degree in a related field such as Health Informatics, Healthcare Administration, Data Analytics, or a similar discipline. A minimum of two (2) years of experience in healthcare data analysis, medical record retrieval, or related areas is required. Candidates with prior experience in Risk Adjustment, managed care, health plan operations, or healthcare analytics will be preferred. A solid understanding of healthcare data, electronic health records (EHRs), and medical record retrieval processes is highly desirable. Proficiency in Microsoft Excel, along with strong analytical, organizational, and communication skills, is essential. The ability to collaborate effectively with providers, vendors, and cross-functional teams is critical to success in this role.
The primary responsibilities of the Risk Adjustment Data Analyst include supporting the organization’s risk adjustment initiatives through comprehensive data analysis and reporting. The analyst will retrieve and validate medical records, ensuring completeness and accuracy for risk adjustment purposes. They will monitor HCC capture and assist in identifying coding opportunities to maximize risk scores. The role involves analyzing provider performance metrics, preparing detailed reports, and supporting regulatory compliance efforts related to CMS requirements. The analyst will also coordinate with external vendors and internal departments to facilitate smooth data flow and accurate reporting. Additionally, the role requires maintaining data integrity, supporting quality improvement initiatives, and staying updated on regulatory changes impacting risk adjustment processes. The analyst will contribute to continuous process improvements by leveraging health informatics tools and analytics platforms, ultimately enhancing the organization’s ability to accurately reflect patient risk profiles and optimize financial performance.
University Health is an equal opportunity employer committed to fostering a diverse and inclusive workplace. We do not discriminate based on race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic. We believe that a diverse workforce enhances our ability to serve our communities effectively and encourages a culture of respect, equity, and inclusion in all aspects of our operations.