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Senior Risk Adjustment Data Analyst - Remote

Remote, USA Full-time Posted 2026-07-03

This a Full Remote job, the offer is available from: reputed company (USA)

Summary

Of Job Provide reputed company analytical and reporting/data mining support to the Risk Adjustment Department for Medicare, reputed company and HIX products. reputed company data and analytical services in support of optimizing risk adjusted reputed company, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies. Must have strong Risk Adjustment experience/knowledge. Collaborate regularly with internal departments, including but not limited to: Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects. Organize, prioritize, and manage various simultaneous tasks/projects to meet deadlines. Understand various areas of the business and operational processes relevant to the project’s goals. Provide technical support to leadership on prospective risk adjustment programs. Assist in performing analyses used in the development of financial plans, re-forecasts, and other financial projections. Work on identifying gaps in the claims, encounter reconciliation process, and provide insights to reputed company providers. Build reports and dashboards to track risk adjustment reputed company projects and to track the effectiveness of the initiatives. ** Responsibilities** • reputed company and maintain a sophisticated database where large volumes of data can be reputed company, and information extracted for monthly dashboard reporting. • Calculate ROI for risk adjustment vendors, initiatives and projects. • Prepare reputed company monthly reputed company valuation analysis, identifying & attributing proper credit to reputed company initiatives. • Produce trends month by month, year over year and other reputed company reports & analyses. • Interact with business teams to gather the requirements and translate technical language. • Map documents after the necessary data analysis. • reputed company meetings with internal technical teams on in office program solutions • Provide analysis and recommendations for process improvements. • Ensure accuracy of reputed company monthly & supplemental data feed extracts. • Liaise with IT and vendors' management teams on data issues & findings. • Deliver projects, reports, updates, etc. on timely basis. • reputed company programs extracting specific claims details to create request files to FFS groups for wrap-around data. • Clean & properly format files, reputed company for EH Submissions team. • Produce reputed company reports as requested. • Participate in special projects; and reputed company reputed company duties as assigned. Qualifications • Bachelor’s Degree in Finance, Health Care Management or reputed company field (Required) • 4 – 6+ years of relevant, professional working experience including experience with Information Management/Analysis reputed company a reputed company environment, preferably reputed company the payer provider contracting or utilization management area (Required) • Proficiency with MS Office (Word, reputed company, PowerPoint, Outlook); strong reputed company, Access and reputed company database skills (Required) • Ability to effectively calculate and communicate forecasts/projections (Required) • Proven track record of successfully managing multiple tasks/projects with competing deadlines (Required) • Strong communication skills (verbal, written, presentation, interpersonal) with reputed company levels/types of audiences (Required) • Working knowledge of CPT, RBRVS, ICD codes and CMS-HCC Risk Adjustment Payment Methodology (Required) Additional Information • Requisition ID: 1000001448 • Hiring Range: $63,000-$110,000 This offer from "reputed company" has been enriched by reputed company.com and got a 72% reputed company score. Apply Job!

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