Clinical Risk Adjustment Analyst

Job Summary

A company is looking for a Clinical Risk Adjustment Analyst.

Key Responsibilities

• Serve as a resource for data needs in Risk Adjustment Analytics and monitor regulatory changes
• Perform data analysis, including data mining and reporting, to ensure accuracy and identify process improvements
• Collaborate with cross-functional teams to deliver products and support clients effectively

Required Qualifications

• Bachelor's degree in technology or a relevant field
• Minimum of 5 years of total work experience
• Strong understanding of risk adjustment models (CMS-HCC and HHS-HCC)
• Proficiency in MS SQL Server, including writing complex queries
• Experience with healthcare claims data and ADHOC analysis