Senior Risk Adjustment Analytics Specialist

Medica Services Company LLC; Minnetonka (MN); On-site; USD 91,000 - 155,000; Full time

Job summary

Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics and reporting that support the organization's risk adjustment strategy. You will translate healthcare data into insights that inform financial performance, coding accuracy, and regulatory compliance.

Operating with minimal supervision, you will own analytics delivered to cross-functional partners and communicate findings clearly.

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 with risk adjustment, Medicare Advantage, or CMS programs strongly preferred.
• Proficiency in SQL and analytics tools (Python, SAS, R) with ability to translate data into actionable insights.

Responsibilities

• Independently develop, maintain, and enhance risk adjustment reporting and analytics, including RAF score performance and financial impact.
• Collaborate with actuarial, finance, clinical, quality, and operational teams to support data-driven decisions.
• Ensure data quality, validation, and reconciliation across analytic outputs.
• Monitor risk adjustment performance indicators and communicate insights to stakeholders.
• Design dashboards and visualizations (Tableau, Power BI) for technical and non-technical audiences.
• Maintain knowledge of CMS risk adjustment guidelines and model changes.
• Identify process improvements and contribute to standardization of analytic approaches.

Skills

Risk adjustment analytics

Data interpretation

Analytical thinking

Communication skills

Stakeholder collaboration

Attention to detail

Education

Bachelor’s degree in Healthcare Analytics or related field

Master’s degree preferred

Tools

SQL

Python

SAS

R

Job description

Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics and reporting that support the organization's risk adjustment strategy. You will translate healthcare data into insights that inform financial performance, coding accuracy, and regulatory compliance.

Operating with minimal supervision, you will own analytics delivered to cross-functional partners and communicate findings clearly.