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Healthcare Risk Adjustment Analyst Jobs (NOW HIRING)

Viva Health

Senior Risk Adjustment Specialist

Birmingham, AL · On-site

$92K/yr

... health care. Our employees are a part of the communities they serve and proudly partner with ... Interpret and demonstrate analytical and problem-solving ability to accurately assign ICD10 codes ...

CommunityCare, Inc.

Strong analytical and critical thinking skills. * Clear written and verbal communication. * Ability ... Successful completion of Health Care Sanctions background check. EDUCATION/EXPERIENCE * A minimum ...

New

Zing Health Holdings Inc

IL · On-site

$85K - $90K/yr

SUMMARY DESCRIPTION The Senior Risk Adjustment Coding Auditor is a highly experienced coding ... matrixed healthcare environment. * Experience utilizing technology and analytics to improve ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Identify opportunities to improve documentation and coding accuracy; provide analysis and ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Identify opportunities to improve documentation and coding accuracy; provide analysis and ...

GeBBS Healthcare Solutions

Risk Adjustment Coder

GeBBS Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping healthcare organizations optimize operations, improve financial performance ...

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How much do healthcare risk adjustment analyst jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for healthcare risk adjustment analyst in the United States is $40.49, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $49.28 per hour, depending on experience, location, and employer.

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Infographic showing various Healthcare Risk Adjustment Analyst job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 67% Full Time, 14% Part Time, and 17% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $84,210 per year, or $40.5 per hour.

Lead Risk Adjustment Data Analyst

New York, NY

EmblemHealth
Insurance Services • 1 - 5K employees
Learn more about EmblemHealthexternal

Full-time

Posted 2 days ago

New

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Summary of Job

Lead the development of building a Risk Adjustment Data Modeling and Analytics tool for submissions to CMS-HCC, HHS-HCC, RX-HCC, CRG.  Enhance efficiencies within the Risk Adjustment team through data optimization by targeting retrospective and prospective solutions through data modeling.  Develop forecasting and efficiency models for contracted Risk Adjustment vendors.  Lead the work and deliverables across multiple, complex projects from the planning stage to implementation, that impact multiple processes to optimize functions within the Risk Adjustment department.  Align and drive strategic Risk Adjustment cost containment initiatives and goals.  Partner with managers, vendors, executive leaders across the enterprise to ensure all workflow processes from Risk Adjustment to their interdependencies are identified and addressed.

Responsibilities

  • Responsible for building and maintaining internal CMS-HCC, HHS-HCC models, their output and analytics for our MA and ACA plans.  
  • Partner with leadership on the development of analytics that forecast vendor spend, premium revenue and efficiency of internal Risk Adjustment programs (collaborations with shared risk\shared savings provider organizations (i.e ACPNY, HCP, and other provider groups) as well as external partners.  
  • Deliver Risk Adjustment modelling outputs that lead the strategic deployment of our vendors as well as reporting on their efficacy by shared risk\shared savings partners.  
  • Partner with External Vendors (i.e Solventum) to gain market insights for NYS Medicaid and Essential Plan and develop models to track.  
  • Partner with the Actuarial Department on model validation and revenue forecasting for all lines of business.  
  • Track progress and communicate project status on a regular basis to all impacted parties.   
  • Work with project owners to develop, align, and refine program management oversight to maximize chances for successful delivery of projects.   
  • Responsible for communicating progress to Enterprise Risk Adjustment leadership and producing status reports presented to the broader Emblem Leadership across Finance, Product, and Provider Network.  
  • Responsible for capturing follow-ups and takeaways from these meetings. 

Qualifications

  • Bachelor's Degree.  
  • Master's Degree in Health or Business Administration  (Preferred)  
  • 5 - 8+ years of related, professional work experience  (Required)  
  • Experience working with Government Sponsored Health Plans  (Required)   
  • Experience working for a vendor or consultant working with Risk Adjustment Modeling, Bid Submissions  (Required)  
  • Experience in a managed care environment or similar highly regulated industry  (Preferred)  
  • Ability to understand and interpret information and to communicate ideas and information to all audiences  (Required)  
  • Proficiency with Data Programming - SQL, Python, SAS  (Required)  
  • Proficiency with Microsoft Suite - Word, Excel, PowerPoint, Outlook, Teams  (Required)   
  • Detail oriented; ability to think independently and to identify and resolve issues and impediments to project success  (Required)  
  • Excellent communication skills - verbal, written, interpersonal, negotiation; ability to build rapport and relationships  (Required)
Additional Information
  • Requisition ID: 1000003353
  • Hiring Range: $77,760-$149,040

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