Risk Adjustment Data Analyst I

Health Care Partners; Village of Garden City (NY); On-site; USD 65,000 - 75,000; Full time

Benefits offered by this job

Base salary and bonus

Robust benefits package

Career growth opportunities

Job summary

HealthCare Partners in Garden City, NY is seeking a Risk Adjustment Integrity Analyst I to join our Quality team. This role supports risk adjustment analytics, data submissions, and regulatory compliance across Medicare, Medicaid, Exchange, and Commercial lines.

The candidate will work with internal teams and vendors to improve data accuracy, lead dashboards, and help ensure accurate risk scores while maintaining strong data governance and documentation practices.

Qualifications

• Bachelor's degree in public health, healthcare administration, business, or data analytics.
• 1–3 years in healthcare risk adjustment or data analytics.
• Experience with CMS audits or RADV is a plus.

Responsibilities

• Analyze risk adjustment and claims data to identify trends, gaps, and improvement opportunities.
• Support design and implementation of risk adjustment strategies across Medicare, Medicaid, and commercial lines.
• Assist with RADV audits by preparing supporting data and documentation.
• Perform data quality checks and reconciliation of CMS file rejections and related reports.
• Collaborate with vendors to track chart retrieval and data validation.
• Develop dashboards, reports, and project trackers for transparency and monitoring.

Skills

SQL

Analytical thinking

CMS risk adjustment familiarity

Excel

Communication skills

Attention to detail

Education

Bachelor’s degree in public health, healthcare administration, business, data analytics

Tools

Python

Tableau

SAS

Excel (advanced)

Job description

HealthCare Partners in Garden City, NY is seeking a Risk Adjustment Integrity Analyst I to join our Quality team. This role supports risk adjustment analytics, data submissions, and regulatory compliance across Medicare, Medicaid, Exchange, and Commercial lines.

The candidate will work with internal teams and vendors to improve data accuracy, lead dashboards, and help ensure accurate risk scores while maintaining strong data governance and documentation practices.