Senior Risk Adjustment Analytics Specialist

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

Benefits offered by this job

Total rewards package

401K contributions

PTO

Job summary

Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) in Minnesota to translate claims data into actionable insights and support financial performance and regulatory compliance.

You will own analytics, collaborate with actuarial, finance, clinical, and operations teams, and ensure data quality while building dashboards for stakeholders. Office role, onsite ~3 days/week near Minnetonka, MN or Madison, WI.

Qualifications

• Bachelor's degree in a related field; Master's preferred.
• Minimum of 3 years in healthcare analytics, reporting, or data analysis.
• Experience supporting risk adjustment, Medicare Advantage, or CMS programs preferred.
• Understanding of CMS risk adjustment methodologies.
• Proficiency in SQL and analytic tools such as Python, SAS, or R.
• Ability to analyze complex data sets and translate results into insights.
• Strong communication and cross-functional collaboration skills.

Responsibilities

• Develop and maintain risk adjustment analytics and reporting, including RAF score and financial impact analysis.
• Collaborate with actuarial, finance, clinical, quality, and operations teams to support data-driven decisions.
• Ensure data quality, validation, and reconciliation processes are in place.
• Monitor risk adjustment performance indicators and communicate findings to stakeholders.
• Design dashboards and visualizations (Tableau, Power BI) for diverse audiences.
• Stay current with CMS guidelines and ensure methodologies align with regulatory requirements.
• Identify process improvements and contribute to standardization of analytics approaches.

Skills

CMS risk adjustment

Analytical skills

Communication & collaboration

Attention to detail

Data interpretation

Education

Bachelor's degree in Healthcare Analytics, Data Analytics, Finance, Economics, Healthcare Administration

Master's degree preferred

Tools

SQL

Python

SAS

R

Job description

Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) in Minnesota to translate claims data into actionable insights and support financial performance and regulatory compliance.

You will own analytics, collaborate with actuarial, finance, clinical, and operations teams, and ensure data quality while building dashboards for stakeholders. Office role, onsite ~3 days/week near Minnetonka, MN or Madison, WI.