Senior Risk Adjustment Data Analyst - Hybrid & AI-Enabled

Blue Shield of California; California (MO); Hybrid; USD 78,000 - 117,000; Full time

Benefits offered by this job

Hybrid workplace

In-office two days per week

Job summary

Blue Shield of California is seeking a data analytics professional to support end-to-end retrospective chart review and risk adjustment analytics in Oakland, CA. The role emphasizes AI-enabled workflows, data validation, and operational reporting to improve efficiency.

You will build Python/SQL solutions, develop dashboards, and collaborate with Clinical, Compliance, and Risk Adjustment teams to ensure accuracy and audit readiness in a hybrid work model.

Qualifications

• Requires college degree or equivalent experience.
• Requires 3 years of healthcare experience, preferably Risk Adjustment.
• Familiarity with AI tools including prompt engineering and workflow automation.
• Experience building dashboards or visual reports to support operational decisions.

Responsibilities

• Analyze data under the supervision of core principles and historical trends.
• Develop and run programs applying analytic decision techniques.
• Design AI-enabled workflows to enhance chart ingestion, data validation, and reporting.
• Automate data processes with Python/SQL and AI applications for vendor data and analytics.

Skills

Data analysis

Python

SQL

Dashboard design

Communication

Education

Bachelor's degree or equivalent experience

Tools

Python

SQL

Job description

Blue Shield of California is seeking a data analytics professional to support end-to-end retrospective chart review and risk adjustment analytics in Oakland, CA. The role emphasizes AI-enabled workflows, data validation, and operational reporting to improve efficiency.

You will build Python/SQL solutions, develop dashboards, and collaborate with Clinical, Compliance, and Risk Adjustment teams to ensure accuracy and audit readiness in a hybrid work model.