Risk Adjustment Data Analyst (Remote - US)

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Risk Adjustment Data Analyst in the United States .

The Risk Adjustment Data Analyst will play a key role in managing and analyzing healthcare data to support accurate risk adjustment calculations and forecasting for Medicare populations. You will work with cross-functional teams to develop automated processes, maintain risk adjustment models, and deliver actionable insights that drive operational and financial decisions. This role requires strong technical skills in SQL, data visualization, and analytics, along with the ability to translate complex datasets into clear reports and dashboards. You will ensure adherence to CMS HCC risk adjustment guidelines while optimizing internal processes and improving reporting efficiency. The position offers a collaborative environment where your work directly impacts the quality and accuracy of healthcare analytics.

Accountabilities :

• Calculate and maintain risk scores for Medicare members using CMS HCC risk adjustment models, incorporating updates and changes from CMS.
• Develop SQL processes to automate risk score calculations and integrate data from multiple sources.
• Analyze project performance and identify value drivers for risk adjustment initiatives.
• Create and automate KPIs specific to risk adjustment, and communicate insights to internal stakeholders.
• Collaborate with Actuarial, Health Economics, and Finance teams to support financial forecasts and projections.
• Build dashboards and automated reporting in Tableau for internal and external stakeholders.
• Provide data and reporting support for practice and provider scorecards.
• Perform additional responsibilities as assigned to support analytics and operational goals.

Requirements

Benefits

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.

When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.

🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.

📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.

🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role.

🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.

The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or assessments) are then made by their internal hiring team.

Thank you for your interest!

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