Risk Adjustment Data Analyst: Drive HCC Capture & Compliance

FetchJobs.co; United States; On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Training & certification support

Career advancement opportunities

Wellness programs

Job summary

University Health is seeking a Risk Adjustment Data Analyst to support its risk adjustment program. You will analyze healthcare data, generate reports, and retrieve medical records while monitoring performance metrics to optimize HCC capture and CMS compliance.

The role involves collaboration with provider networks, internal teams, and external vendors to ensure accurate data collection and timely reporting.

Qualifications

• Bachelor's degree in a related field such as health information management, healthcare administration, or data analytics.
• Minimum of two years of experience in healthcare data analysis and medical record retrieval.
• Prior experience in Risk Adjustment, managed care, health plan operations, or healthcare analytics preferred.
• Strong understanding of healthcare data, EHRs, and the medical record retrieval process.
• Proficiency in Microsoft Excel is essential; ability to work with providers, vendors, and cross-functional teams is crucial.

Responsibilities

• Analyzing healthcare data to identify trends and opportunities for improving risk adjustment outcomes.
• Generating comprehensive reports to monitor performance metrics and HCC capture rates.
• Coordinating with provider networks and internal teams to facilitate medical record retrieval and data collection.
• Validating data accuracy and ensuring CMS and organizational compliance.
• Supporting documentation and coding improvements for risk adjustment purposes.
• Assisting with regulatory reporting, CMS submissions, and audits.
• Using Power BI or similar analytics tools to support data-driven decision-making.
• Collaborating with external vendors and internal departments to streamline data processes and improve data quality.
• Providing training and ongoing support to staff and providers on data collection best practices.

Skills

Analytical thinking

Strong communication

Cross-functional collaboration

Attention to detail

Education

Bachelor's degree in Health Information Management/Healthcare Administration/Data Analytics

Tools

Microsoft Excel

Power BI

Job description

University Health is seeking a Risk Adjustment Data Analyst to support its risk adjustment program. You will analyze healthcare data, generate reports, and retrieve medical records while monitoring performance metrics to optimize HCC capture and CMS compliance.

The role involves collaboration with provider networks, internal teams, and external vendors to ensure accurate data collection and timely reporting.