Senior Risk Adjustment Data Analyst (Hybrid)

Ultipro; Minnetonka (MN); Hybrid; USD 91,000 - 123,000; Full time

Benefits offered by this job

Medical, dental, vision

PTO and holidays

401K contributions

Caregiver services

Job summary

Medica is seeking a Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics supporting the organization’s risk adjustment strategy. The role translates healthcare and claims data into actionable insights for financial performance, coding accuracy, and regulatory compliance.

Operating with minimal supervision, you will own analytics deliverables and partner with actuarial, finance, clinical, and operational teams.

Qualifications

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

Responsibilities

• Develop, maintain, and enhance risk adjustment reporting and analytics, including RAF score and financial impact analysis.
• Collaborate with actuarial, finance, clinical, quality, and operations partners to explain results and implications.
• Ensure data quality through validation and reconciliation; identify issues and recommend corrective actions.
• Monitor key risk adjustment indicators and communicate findings to stakeholders.
• Design dashboards and visuals (Tableau, Power BI) to convey complex findings to diverse audiences.
• Maintain knowledge of CMS risk adjustment guidelines and ensure regulatory alignment.
• Identify opportunities to improve analytics processes and documentation.

Skills

CMS risk adjustment methodologies

Analytical thinking

Communication

Attention to detail

Team collaboration

Data storytelling

Education

Bachelor’s degree in related field

Master’s degree preferred

Tools

SQL

Python

SAS

R

Job description

Medica is seeking a Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics supporting the organization’s risk adjustment strategy. The role translates healthcare and claims data into actionable insights for financial performance, coding accuracy, and regulatory compliance.

Operating with minimal supervision, you will own analytics deliverables and partner with actuarial, finance, clinical, and operational teams.