Senior Healthcare Risk Adjustment Analyst

RiseMe; Minnetonka (MN); On-site; USD 91,000 - 155,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

PTO

Holidays

401K

Volunteer time off

Job summary

Medica is a nonprofit health plan delivering care to communities in Minnesota and beyond. The Risk Adjustment Healthcare Analyst (P3) is a senior IC responsible for translating healthcare data into actionable insights supporting financial performance, coding accuracy, and regulatory compliance.

You will work with actuarial, finance, clinical, and operations teams from an expert analytical standpoint. This on-site role (3 days/week) is based near Minnetonka, MN or Madison, WI, with a salary range

Qualifications

• Bachelor’s degree in Healthcare Analytics, Data Analytics, Finance, Economics, Healthcare Administration, or related field.
• Master’s degree preferred.
• Minimum of 3 years of experience in healthcare analytics, reporting, or data analysis.
• Experience supporting risk adjustment, Medicare Advantage, or CMS-related programs strongly preferred.

Responsibilities

• Develop, maintain, and enhance complex risk adjustment reporting and analytic solutions, including HCC coding accuracy and RAF score performance.
• Collaborate with actuarial, finance, clinical, quality, and operational partners to support data-driven decision-making.
• Ensure data integrity through validation and reconciliation processes and address quality issues.
• Monitor risk adjustment performance indicators and communicate findings to stakeholders.
• Design and deliver dashboards and visualizations (Tableau, Power BI) for technical and non-technical audiences.
• Maintain knowledge of CMS risk adjustment guidelines and model changes.
• Identify opportunities to improve analytic processes and documentation within the team.

Skills

HHS/CMS risk adjustment

SQL

Python

SAS

R

Data analytics

Communication

Attention to detail

Education

Bachelor’s degree in Healthcare Analytics / related field

Master’s degree preferred

Tools

SQL

Python

SAS

R

Job description

Medica is a nonprofit health plan delivering care to communities in Minnesota and beyond. The Risk Adjustment Healthcare Analyst (P3) is a senior IC responsible for translating healthcare data into actionable insights supporting financial performance, coding accuracy, and regulatory compliance.

You will work with actuarial, finance, clinical, and operations teams from an expert analytical standpoint. This on-site role (3 days/week) is based near Minnetonka, MN or Madison, WI, with a salary range