Strategic Health Data Analyst – Risk Adjustment

St. Luke's Health System; Boise (ID); On-site; USD 90,000 - 130,000; Full time

Job summary

St. Luke’s Health System is seeking a Risk Adjustment Analyst to partner with business segments within St. Luke’s Health Plan.

The role leads development of processes and delivers insights from health insurance data, collaborating with cross‑functional stakeholders to improve risk adjustment for QHP/ACA and Medicare Advantage. The successful candidate will analyze eligibility, premiums, claims data, and regulatory requirements, and will support data governance and data quality across projects.

Qualifications

• Bachelor’s degree or experience in lieu of degree.
• Six years of relevant experience.

Responsibilities

• Analyze and interpret health insurance data to support decision making.
• Translate complex data into actionable insights for business leaders.
• Collaborate with Data & Analytics and vendors to ensure data quality and governance.
• Lead and participate in special projects within the risk adjustment domain.
• Support QHP/ACA and Medicare Advantage risk adjustment processes and submissions.

Skills

SQL

Health data analysis

Risk adjustment analytics

Cross-functional collaboration

Regulatory knowledge

Education

Bachelor’s degree or experience in lieu of degree

Tools

EDGE Server Data Submission

Job description

St. Luke’s Health System is seeking a Risk Adjustment Analyst to partner with business segments within St. Luke’s Health Plan.

The role leads development of processes and delivers insights from health insurance data, collaborating with cross‑functional stakeholders to improve risk adjustment for QHP/ACA and Medicare Advantage. The successful candidate will analyze eligibility, premiums, claims data, and regulatory requirements, and will support data governance and data quality across projects.