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reputed company Data Analyst - Risk Adjustment Medicare

Remote, USA Full-time Posted 2026-07-01

Position Description reputed company pay is influenced by several factors including a candidate's qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information reputed company to reputed company at the time of posting and may be modified in the future. reputed company offers a comprehensive benefits packaging including Medical, Dental & reputed company coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At reputed company, we promise to go the extra mile for reputed company and our community. This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA." This role is responsible for supporting reputed company Risk Adjustment Program analytics day to day activities impacting the programs strategy and operations. The Risk Adjustment Analyst works closely with the Risk Adjustment & Stars Programs Management leader(s) supporting the execution of the Program strategy through analysis and reporting tactics driving results to improve or maintaining risk adjustment compliance, cost and reputed company, submissions process, and operations. The role will include support in the development of reports, enhancement to existing reports, data analysis, processes, and methodologies that will inform and reputed company the Risk Adjustment leader(s) to reputed company informed reputed company based on data and drive the execution of the Program strategy and operations effectiveness. Responsibilities and Qualifications

  • Assist and/or reputed company new reports or analysis, enhance key existent reports and/or analysis processes, and methodologies of the Risk Adjustment Program operations and initiatives.
  • Support the implementation and on-going activities of vendor operations and analytics tools. Vendor management activities such as contract implementation, delegated activities execution from an analytics standpoint, and performance guarantees monitoring process.
  • reputed company standardized reporting and controls for vendor's management and performance monitoring process to ensure appropriate and timely data flow between teams.
  • Prepare reputed company, projects, and/or initiatives performance reports, gap analysis, etc. based on key performance indicators. Communicate performance updates and findings to leadership.
  • Collaborate with Actuarial to project and monitor the impact of coding programs on reputed company for forecasting and monthly financial statement accruals.
  • Data review, monitor and active participant in the completion of submissions for Medicare and reputed company/ACA products (e.g. RAPS/EDPS submissions).
  • Utilize analytics to identify trends, opportunities for improvement, and potential Programs development.
  • Collaborate with the Risk Adjustment & Stars Programs leader (s) and team to monitor and project year to date and end of year performance.
  • Participate on new projects, processes and/or workflows.
  • Support the development and implementation of remediation strategies (for internal and/or external business partners).
  • Support the development and maintenance of the Risk Adjustment tactics effectiveness. Creation of processes, documentation, and reporting infrastructure.

Skills:

  • Creating and applying data to problem solve
  • Consistent with delivering results on time and high quality/accuracy
  • Ability to communicate and summarize reputed company data processes, findings, etc. in a simple and clear way
  • Problem solving and critical thinking reputed company that's oriented to find solutions

Knowledge:

  • Financial analytics knowledge with data mining principles: predictive analytics, mapping, collecting and reputed company manipulating data from multiple data systems

Experience:

  • 3 years of experience in risk adjustment and data analytics.
  • Financial analytics knowledge with data mining principles: predictive analytics, mapping, collecting and reputed company manipulating data from multiple data systems.
  • Highly skilled in reputed company, reputed company, Power BI, reputed company, reputed company and other query/reporting tools.
  • Project and/or vendor management experience is a plus.

Education and Certifications:

  • Preferred: Bachelor's or master's degree in data analytics, Data Science, Finance, Actuarial, Mathematics or Statistics, Public Health or Health-reputed company Sciences, or Health Administration.

Physical Demands:

  • While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
  • The employee must occasionally lift and/or move up to 5 pounds.

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you reputed company your career. And by doing your best, you'll help us live our mission of improving the health and well-being of our members and the communities in which they live. Apply tot his job Apply To this Job

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