Risk Adjustment Healthcare Analyst

JOB REQUIREMENTS: Description Medica is a nonprofit health plan withmore than a million members that serves communities in Minnesota,Nebraska, Wisconsin, Missouri, and beyond. We deliver personalizedhealth care experiences and partner closely with providers to ensuremembers are genuinely cared for. We're a team that owns our work withaccountability, makes data-driven decisions, embraces continuouslearning, and celebrates collaboration - because success is a teamsport. It's our mission to be there in the moments that matter most forour members and employees. Join us in creating a community of connectedcare, where coordinated, quality service is the norm and every memberfeels valued. The Risk Adjustment Healthcare Analyst (P3) is asenior-level individual contributor responsible for delivering complex,high-impact analytics and reporting that supports the organization'sRisk Adjustment strategy. This role translates healthcare and claimsdata into actionable insights that inform financial performance, codingaccuracy, and regulatory compliance. Operating with minimal supervision,the analyst independently owns assigned analytics and reportingdeliverables and serves as a trusted analytical resource tocross-functional partners including actuarial, finance, clinical, andoperational teams. The role requires strong applied analytics expertise,solid understanding of CMS risk adjustment methodologies, and theability to clearly communicate insights to diverse audiences. KeyAccountabilities Risk Adjustment Analytics & Reporting Independentlydevelop, maintain, and enhance complex risk adjustment reporting andanalytic solutions, including HCC coding accuracy, RAF scoreperformance, and financial impact analysis. Ensure outputs are accurate,timely, and aligned with business needs. Cross-Functional PartnershipCollaborate closely with actuarial, finance, clinical, quality, andoperational partners to support data-driven decision-making. Serve as ananalytical resource by explaining results, assumptions, and implicationsof risk adjustment analytics. Data Quality & Validation Ensure theintegrity, consistency, and reliability of risk adjustment data throughestablished validation and reconciliation processes. Identify dataquality issues, conduct root-cause analysis, and recommend correctiveactions. Performance Monitoring & Insight Generation Monitor and analyzekey risk adjustment performance indicators. Identify trends, variances,and anomalies, and proactively communicate findings and implications tostakeholders. Data Visualization & Communication Design and deliverdashboards and visualizations (e.g., Tableau, Power BI) that clearlycommunicate complex analytical findings to technical and non-technicalaudiences. Regulatory & Methodology Awareness Maintain working knowledgeof CMS risk adjustment guidelines and model... For full info followapplication link. Equal Opportunity Employer including Veterans andDisabled Individuals APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/97758D28D2FA49C3

Created: 2026-05-02