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Healthcare Risk Analyst Jobs in Raleigh, NC (NOW HIRING)

Merz North America

Credit Analyst

Raleigh, NC · On-site

About Us Founded in 1908, Merz is a successful, family-owned specialty healthcare company with a ... They assess credit risk and the credit worthiness of new and existing customers. The credit analyst ...

CenterWell

Data Engineer - Healthcare

Raleigh, NC · Remote

$111K - $133K/yr

Assess complex data sets and conduct root cause analysis. * Experience using data to improve ... Risk Adjustment, and quality metrics (such as HEDIS). * Experience working with Snowflake Cloud.

BHDP

Architect | Healthcare

Raleigh, NC · On-site

Market: Healthcare Location: Raleigh, NC FLSA: Exempt Work Mode: Monday - Friday; 8:00 - 5:00; In ... Escalates high-risk items, documents key decisions, drives consistent implementation across the ...

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All JobsHealthcare Risk Analyst JobsHealthcare Risk Analyst Jobs in Raleigh, NC

Healthcare Risk Analyst information

See Raleigh, NC salary details

$14

$39

$64

How much do healthcare risk analyst jobs pay per hour?

As of Jun 8, 2026, the average hourly pay for healthcare risk analyst in Raleigh, NC is $39.36, according to ZipRecruiter salary data. Most workers in this role earn between $28.99 and $47.88 per hour, depending on experience, location, and employer.

What does a Healthcare Risk Analyst do?

A Healthcare Risk Analyst is responsible for identifying, assessing, and minimizing risks within healthcare organizations to ensure patient safety and regulatory compliance. They analyze data on incidents, adverse events, and potential liabilities, then develop strategies to mitigate those risks. Their work often involves collaborating with medical staff, administrators, and legal teams to implement policies and training that reduce the likelihood of errors or accidents. Ultimately, their goal is to protect patients, staff, and the organization from harm and financial loss.

How does a Healthcare Risk Analyst typically collaborate with clinical staff to identify and mitigate potential risks in a healthcare setting?

Healthcare Risk Analysts frequently work alongside nurses, physicians, and other clinical staff to identify areas where patient safety and regulatory compliance could be improved. This often involves reviewing incident reports, facilitating root cause analyses, and leading or participating in multidisciplinary meetings to discuss risk trends and develop preventative strategies. Effective communication and relationship-building skills are essential, as analysts must translate complex data findings into practical recommendations that clinical teams can implement. This collaborative approach helps create a culture of safety and continuous improvement throughout the healthcare organization.

What is the difference between Healthcare Risk Analyst vs Healthcare Data Analyst?

AspectHealthcare Risk AnalystHealthcare Data Analyst
Required CredentialsBachelor's degree in healthcare, risk management, or related field; certifications like RAC or ARM beneficialBachelor's degree in healthcare, statistics, or data analysis; certifications like CPC or Certified Health Data Analyst helpful
Work EnvironmentHealthcare organizations, insurance companies, risk management departmentsHospitals, clinics, healthcare IT firms, insurance companies
Employer & Industry UsageFocuses on assessing and mitigating risks within healthcare settingsAnalyzes healthcare data to improve patient outcomes and operational efficiency

The Healthcare Risk Analyst primarily evaluates and manages risks in healthcare settings, often working with insurance and compliance teams. In contrast, the Healthcare Data Analyst focuses on analyzing healthcare data to support decision-making and improve healthcare delivery. While both roles require analytical skills and healthcare knowledge, their core responsibilities and work environments differ.

What are the key skills and qualifications needed to thrive as a Healthcare Risk Analyst, and why are they important?

To thrive as a Healthcare Risk Analyst, you need strong analytical abilities, knowledge of healthcare regulations, and a degree in healthcare administration, risk management, or a related field. Familiarity with risk management software, incident reporting systems, and data analysis tools like Excel or SAS is typically required. Attention to detail, critical thinking, and effective communication are crucial soft skills for identifying potential risks and collaborating with multidisciplinary teams. These skills and qualities are vital for proactively managing risks, ensuring regulatory compliance, and protecting patient safety within healthcare organizations.
What are popular job titles related to Healthcare Risk Analyst jobs in Raleigh, NC? For Healthcare Risk Analyst jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Healthcare Risk Analyst jobs in Raleigh, NC look for? The top searched job categories for Healthcare Risk Analyst jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Healthcare Risk Analyst jobs? Cities near Raleigh, NC with the most Healthcare Risk Analyst job openings:
Healthcare Risk Analyst jobs near you
Senior Healthcare Data Analyst: ACA + EDGE

Senior Healthcare Data Analyst: ACA + EDGE

Blue Cross and Blue Shield of North Carolina

Durham, NC

$77K - $98K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

165th of 260 rated insurance

Job description

Job Description

We are seeking a highly skilled Senior Data Analyst with deep expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissions. This role will serve as a key liaison between business stakeholders, risk adjustment operations, and technical teams to ensure the accuracy, completeness, and timeliness of EDGE data submissions and reporting.
The ideal candidate will have strong experience with ACA data flows (enrollment, claims, supplemental), HCC modeling, and reconciliation of EDGE outputs, along with advanced analytical and data validation skills.
In this role you will be responsible for providing complex analytic support, which includes data collection, trending, reporting and forecasting functions to effectively assist departments/divisions with decision making. Prepares complex data for various internal and external customers, such as Department of Insurance (DOI), lawyers, external auditors, contracting vendors, employee groups, internal physician and hospital contracting staff, financial/medical expense staff and other divisions/programs.

What You'll Do

  • Construct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports) to gather statistical data, ensuring that the most efficient procedures are used to access, investigate, and analyze data.

  • Develop, analyze, report and interpret complex data for ongoing activities/projects. Ensure that all data is accurate and available to meet establish deadlines.

  • Work collaboratively with customers to complete effective needs analyses to successfully provide analytic support and problem solving assistance to business areas.

  • Monitor and perform in-depth analysis of data for customers to determine areas of improvement or where investigation is needed.

  • Identify complex data problems and issues and is responsible for resolution.

  • Identify complex trends and make recommendations to business areas to effectively assist them with decision making on operational or other business issues.

  • Communicate meaningful insights by creating charts and slide presentations and presenting findings to all levels of leadership staff.

  • Maintain and coordinate existing cross-functional programs, and create and develop new programs.

  • Support and manage complex applications systems on many platforms and manage code migrations and changes between different applications environments.

  • Develop, maintain, and monitor reports on system security to ensure user access is appropriate for the specific division. Provide ongoing user support for ad hoc reporting, questions, queries, and problem support

  • Ensure appropriate security and privacy for all data that contains PHI fields. Resolve all security and privacy issues in the data.

  • Represent department on enterprise project teams and process optimization efforts as needed.

  • Serve as a mentor/coach for less experienced employees.

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • 5+ years of experience in related field.

  • In lieu of degree, 7+ years of experience in related field.

WhatYou'llGet

  • The opportunity to work at thecutting edgeof health care delivery with a teamthat'sdeeply invested in the community

  • Work-life balance, flexibility, and the autonomy to dogreat work

  • Medical, dental, and vision coverage along withnumeroushealth and wellness programs

  • Parental leave and support plus adoption and surrogacyassistance

  • Career development programs and tuition reimbursement for continued education

  • 401k match including an annual company contribution

  • Learn more

WhereYou'llWork

Our Hybrid Flex approach is builton presencewith a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplacethat'sflexible, connected, and future focused.

In a Hybrid-Flex role,you'llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you'llwork virtually, with a few in-office visits each year formeaningfulmoments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$89,174.00 - $142,679.00

Skills

Business Analysis, Business Data Analysis, Business Intelligence (BI), Cloud Applications, Code Collaborator, Communication, Consulting, Data Warehousing (DW), Health Insurance Industry, Peer Development, Problem Solving, Statistical Models, Structured Query Language (SQL)

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

What Blue Cross and Blue Shield of North Carolina employees say

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