Senior Risk Adjustment Data Analyst

Central California Alliance for Health; California, Scotts Valley (MO, CA); Hybrid; USD 88,000 - 156,000; Full time

Job summary

Join a forward-thinking organization as a Senior Risk Adjustment Data Analyst, where you'll leverage your expertise in SQL and data visualization to drive impactful healthcare insights. This role involves complex data analysis and collaboration with diverse teams to enhance risk adjustment performance across Medicare and Medi-Cal programs. Embrace a hybrid work environment that values your contributions and fosters a culture of respect and empowerment. If you're passionate about improving health outcomes and ensuring regulatory compliance, this opportunity is perfect for you.

Benefits

Medical, Dental, and Vision Plans

Paid Time Off and Holidays

Retirement and Deferred Compensation Plans

Health and Wellness Programs

Onsite EV Charging Stations

Qualifications

• 5+ years of healthcare finance reporting and analytics experience.
• Knowledge of Medicare regulations and Hierarchical Condition Categories.

Responsibilities

• Perform complex analytical data mining and reporting for risk adjustment.
• Lead initiatives and manage projects related to data gathering and analysis.

Skills

SQL

Data Visualization (Tableau)

Risk Adjustment Methodologies

Quantitative Data Analysis

Collaboration Skills

Education

Bachelor's Degree in Finance, Business, IT

Master's Degree (preferred)

Tools

Microsoft Teams

Job description

Senior Risk Adjustment Data Analyst

Location: Remote; California

We have an opportunity to join the Alliance as a Senior Risk Adjustment Data Analyst in the Risk Adjustment Department.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Risk Adjustment Director, this position performs complex analytical data mining and reporting to support the Risk Adjustment Department. You will lead initiatives, provide program support, and manage projects related to data gathering and analysis. You will also act as a subject matter expert regarding risk adjustment data.

ABOUT THE TEAM

Risk Adjustment is a growing team that ensures accurate coding, appropriate reimbursement, and data-driven insights to support organizational goals. The team collaborates with internal and external partners to optimize risk adjustment performance across Medicare and Medi-Cal programs, aiming to improve health outcomes and ensure regulatory compliance.

THE IDEAL CANDIDATE

• Well-versed in risk adjustment methodologies, especially within Medicare
• Familiar with risk adjustment models and their impact on plan performance and payment
• Proficient in SQL and capable of analyzing healthcare data to produce meaningful insights and reports
• Experienced with data visualization tools like Tableau
• Self-directed, proactive, and able to manage priorities and drive projects
• Collaborative, working effectively with diverse organizational teams
• Medicaid/Medi-Cal experience is a plus

WHAT YOU'LL NEED TO BE SUCCESSFUL

For the full position description and requirements, click here.

• Knowledge of:
• Quantitative data analysis methodologies and tools related to risk adjustment
• Data modeling, SQL, and visualization tools like Tableau
• Medicare regulations and Hierarchical Condition Categories (HCC) models
• Data management strategies for contract analysis, trend management, budgeting, and healthcare operations
• Ability to:
• Interpret and evaluate data, identify patterns, and develop solutions
• Troubleshoot and resolve complex problems
• Provide guidance and explain regulations and processes
• Collaborate effectively with project teams
• Education and Experience:
• Bachelor's degree in Finance, Business, IT, or related field
• At least five years of healthcare finance reporting and analytics experience, including three in Medicare (Master's degree may substitute for two years)

OTHER INFORMATION

• Hybrid work environment; remote interviews via Microsoft Teams
• Attendance at quarterly company-wide events or meetings may be required
• In-office presence may be needed based on business needs

COMPENSATION

The full range varies by location:

• Zone 1 (Bay Area, Sacramento, Los Angeles, San Diego): $96,979 - $155,168 USD
• Zone 2 (Fresno, Bakersfield, Central Valley, Eastern California, Eureka): $88,251 - $141,211 USD

OUR BENEFITS

Benefits are available for employees working more than 30 hours/week, including:

• Medical, Dental, and Vision Plans
• Paid Time Off and Holidays
• Retirement and Deferred Compensation Plans
• Health and Wellness Programs
• Onsite EV Charging Stations

ABOUT US

We are a dedicated team of over 500 employees committed to accessible, quality healthcare. Join us at Central California Alliance for Health, where our culture is respectful, diverse, and empowering. We serve multiple counties and are committed to community impact.

We are an equal opportunity employer and participate in E-Verify. Currently, we do not sponsor work visas; applicants must be authorized to work in the U.S. full-time.