Senior Risk Adjustment Analyst
Job Summary
Working remotely in a full-time capacity, the Senior Risk Adjustment Analyst will support Medicare Advantage and ACA Risk Adjustment programs by managing risk adjustment analytics and improving coding capture and revenue optimization.
Key responsibilities
- Perform risk adjustment analytics focused on RAF improvement and financial impact analysis
- Develop and execute complex SQL queries for data validation and reporting purposes
- Collaborate with cross-functional teams to enhance risk adjustment processes and outcomes
Required qualifications
- 3+ years of advanced SQL development experience, including writing complex queries and joins
- Hands-on experience supporting Medicare Advantage and/or ACA Risk Adjustment programs
- Direct experience with CMS-HCC and/or RxHCC risk adjustment models
- Proven track record in risk adjustment analytics focused on revenue optimization
Complete Job Description
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