Senior Risk Adjustment Analytics Lead – HCC & RAF Insights

Medica; Minnetonka (MN); On-site; USD 91,000 - 123,000; Full time

Benefits offered by this job

Competitive medical benefits

Dental and vision coverage

Paid time off (PTO)

Paid holidays

Volunteer time off

401K contributions

Caregiver services

Job summary

Medica, a nonprofit health plan serving Minnesota, is seeking a Risk Adjustment Healthcare Analyst (P3). This senior contributor translates claims data into insights that inform financial performance, coding accuracy, and regulatory compliance, partnering with actuarial, finance, clinical, and operational teams.

The role requires strong applied analytics, CMS risk adjustment knowledge, and the ability to communicate results to diverse audiences.

Qualifications

• Bachelor's degree in a related field; master's preferred.
• 3+ years in healthcare analytics, reporting, or data analysis.
• Experience with risk adjustment, Medicare Advantage, or CMS programs preferred.

Responsibilities

• Develop, maintain, and enhance risk adjustment reporting and analytics.
• Collaborate with actuarial, finance, clinical, quality, and operations teams.
• Ensure data quality, validation, and reconciliation of risk adjustment data.
• Monitor performance indicators and communicate insights to stakeholders.
• Design dashboards and visuals (Tableau, Power BI) for diverse audiences.
• Maintain knowledge of CMS risk adjustment guidelines and methodologies.

Skills

Analytics

Communication

Attention to Detail

Team Collaboration

Education

Bachelor's degree in Healthcare Analytics

Master's degree preferred

Tools

SQL

Python

SAS

R

Job description

Medica, a nonprofit health plan serving Minnesota, is seeking a Risk Adjustment Healthcare Analyst (P3). This senior contributor translates claims data into insights that inform financial performance, coding accuracy, and regulatory compliance, partnering with actuarial, finance, clinical, and operational teams.

The role requires strong applied analytics, CMS risk adjustment knowledge, and the ability to communicate results to diverse audiences.