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Hueman Risk Adjustment Solutions Jobs in Missouri

Centene

Senior Business Technical Analyst

Columbia, MO

$87K - $157K/yr

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

Allianz

Portfolios Solutions Analyst

O Fallon, MO · On-site

Map, upload, analyze, and report on bordereaux and underlying data for risk, premium, and claims ... If you require adjustments during the application process, please email agcsglobalcareers@allianz ...

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Hueman Risk Adjustment Solutions information

What is Hueman Risk Adjustment Solutions?

Hueman Risk Adjustment Solutions is a company that specializes in providing risk adjustment services for healthcare organizations. Their solutions help healthcare providers accurately capture and report patient health data to ensure proper reimbursement and compliance with government programs like Medicare Advantage. They offer services such as coding, chart reviews, and analytics to improve risk score accuracy and optimize revenue cycles. Hueman's approach is designed to enhance the quality of care documentation and support organizations in navigating the complexities of value-based care.

What are the key skills and qualifications needed to thrive as a risk adjustment specialist at Hueman Risk Adjustment Solutions?

To thrive as a Risk Adjustment Specialist, you need a strong background in medical coding, healthcare data analysis, and a comprehensive understanding of risk adjustment models, typically supported by certifications such as CRC, CPC, or CCS. Familiarity with coding software, electronic health records (EHR) systems, and risk adjustment platforms is essential. Attention to detail, analytical thinking, and effective communication are standout soft skills in this role. These skills ensure accurate coding, compliance with regulatory standards, and optimal reimbursement outcomes for healthcare organizations.

What are some typical challenges faced by professionals working in risk adjustment solutions at Hueman, and how can they be addressed?

Professionals in Risk Adjustment Solutions at Hueman often encounter challenges such as accurately interpreting complex medical records and ensuring compliance with evolving healthcare regulations. Maintaining high data quality while meeting deadlines can also be demanding, especially when working with large volumes of patient information. These challenges are best addressed by leveraging advanced coding tools, participating in ongoing training, and collaborating closely with clinical staff and data analysts. This teamwork and commitment to best practices help ensure accurate risk adjustment and contribute to improved patient outcomes.

What is the difference between Hueman Risk Adjustment Solutions vs Medical Coding Specialist?

AspectHueman Risk Adjustment SolutionsMedical Coding Specialist
CredentialsCertifications in risk adjustment, coding, or related fieldsCertified Professional Coder (CPC), CCS, or equivalent
Work EnvironmentConsulting, healthcare analytics, risk adjustment programsHospitals, clinics, insurance companies
Industry UsageHealth plan risk management, analytics firmsMedical billing, coding departments

Hueman Risk Adjustment Solutions focuses on optimizing risk adjustment processes through analytics and consulting, while Medical Coding Specialists handle the accurate coding of medical records. Both roles require coding certifications but differ in scope and work environment, with Hueman primarily providing strategic solutions and Medical Coding Specialists executing coding tasks within healthcare facilities.

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For Hueman Risk Adjustment Solutions jobs in Missouri, the most frequently searched job titles are:

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Cities in Missouri with the most Hueman Risk Adjustment Solutions job openings:

Hueman Risk Adjustment Solutions jobs near you
Infographic showing various Hueman Risk Adjustment Solutions job openings in Missouri as of June 2026, with employment types broken down into 86% Full Time, and 14% Contract. Highlights an 78% In-person, 8% Hybrid, and 14% Remote job distribution.

Senior Business Technical Analyst

SoTalent

Jefferson City, MO • On-site

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Senior Business Technical Analyst

📍 Location: Jefferson City, MO, US

🏢 Industry: Hospital and healthcare

💼 Work Setting: Hybrid


Are you a senior technical analyst with expertise in healthcare data, Risk Adjustment, SAS, SQL, and modern cloud data platforms?

We are seeking a Senior Business Technical Analyst (Sr. BTA) to bridge Medicare Advantage and Medicaid Risk Adjustment business requirements with scalable, production-ready technical solutions. This role is responsible for translating complex business needs into system designs, advanced data solutions, automation frameworks, and Snowflake modernization initiatives that support compliant Risk Adjustment operations and regulatory reporting.

The ideal candidate combines expertise in healthcare analytics, Risk Adjustment, SAS development, SQL engineering, Snowflake architecture, data quality, regulatory compliance, and business analysis with strong stakeholder management and technical leadership capabilities.


Key Responsibilities

Business & Technical Analysis

  • Partner with:
  • Risk Adjustment Teams
  • Business Analysts
  • IT Teams
  • Vendor Partners
  • Healthcare Operations Stakeholders
  • Translate Medicare Advantage and Medicaid requirements into technical specifications.
  • Analyze operational procedures, workflows, and business challenges.
  • Recommend technical solutions that support organizational goals.
  • Serve as a bridge between business and technology teams.

Risk Adjustment Solutions Development

  • Support:
  • Encounter Risk Adjustment Prioritization
  • Encounter Risk Adjustment Chart Processes
  • Encounter Submission Workflows
  • Regulatory Reporting Requirements
  • Convert business requirements into scalable technical solutions.
  • Design and maintain production-ready Risk Adjustment data processes.
  • Improve workflow automation and operational efficiency.

SAS Development & Data Engineering

  • Develop, maintain, and enhance advanced SAS solutions.
  • Create production-ready SAS code for:
  • Data Processing
  • Risk Adjustment Analytics
  • Validation Activities
  • Reporting Workflows
  • Build reusable code libraries and shared assets.
  • Support enterprise reporting and healthcare operations.

Snowflake Modernization & Cloud Data Architecture

  • Lead modernization efforts migrating legacy SAS workflows to Snowflake.
  • Design cloud-native solutions using:
  • Snowflake SQL
  • Snowpark Python
  • Tasks
  • Streams
  • Automated Data Pipelines
  • Improve scalability, maintainability, and performance of data platforms.
  • Support long-term cloud transformation strategies.

Healthcare Data Integration

  • Integrate and manage complex healthcare datasets including:
  • Claims Data
  • Enrollment Data
  • Provider Data
  • Pharmacy Data
  • Clinical Data
  • Vendor Chart Data
  • Encounter Data
  • Build robust and scalable healthcare data repositories.
  • Ensure consistency and reliability across data sources.
  • Support enterprise data management initiatives.

Data Modeling & Database Solutions

  • Design real-time, multi-user database solutions.
  • Develop scalable data structures supporting healthcare analytics.
  • Optimize database performance and accessibility.
  • Ensure systems support business and regulatory requirements.
  • Contribute to enterprise data architecture improvements.

Data Quality, Validation & Compliance

  • Implement frameworks supporting:
  • Data Quality
  • Data Validation
  • Reconciliation
  • Audit Readiness
  • Regulatory Compliance
  • Ensure adherence to:
  • CMS Requirements
  • Medicaid Regulations
  • Risk Adjustment Standards
  • Internal Governance Policies
  • Support accurate and compliant encounter submissions.

Reporting & Analytics

  • Develop ad-hoc reports and analytical solutions.
  • Perform:
  • Data Validation
  • Trend Analysis
  • Operational Assessments
  • Financial Impact Analysis
  • Provide actionable insights supporting business decisions.
  • Support reporting requirements across departments.

System Design & Technical Documentation

  • Create:
  • Technical Specifications
  • System Design Documents
  • Process Documentation
  • Data Flow Diagrams
  • Knowledge Transfer Materials
  • Maintain detailed technical documentation.
  • Support development consistency and long-term maintainability.
  • Enable effective collaboration across teams.

Project & Stakeholder Management

  • Monitor project progress and support delivery milestones.
  • Identify project risks and develop mitigation strategies.
  • Communicate status updates to management and stakeholders.
  • Facilitate alignment between technical and business teams.
  • Support successful implementation of strategic initiatives.

Technical Leadership & Mentorship

  • Act as a subject matter expert for Risk Adjustment data solutions.
  • Provide guidance and training to team members.
  • Support issue resolution and operational improvements.
  • Promote best practices across development and analytics teams.
  • Contribute to technical capability development.


Qualifications

Education

Required

  • Bachelor's Degree in:
  • Computer Science
  • Information Systems
  • Data Analytics
  • Mathematics
  • Engineering
  • Related Technical Field

Preferred

  • Master's Degree in:
  • Computer Science
  • Mathematics
  • Data Science
  • Related Discipline

Required Experience

  • Experience conducting:
  • Technical Data Analysis
  • Business Analysis
  • Systems Analysis
  • Requirements Gathering
  • Technical Design
  • Project Planning
  • Experience developing technical solutions based on business requirements.


Preferred Experience

Healthcare

  • 1+ years in Healthcare Data Management.
  • Experience with:
  • Medicare Advantage
  • Medicaid
  • Risk Adjustment Programs
  • Encounter Submissions
  • Healthcare Regulatory Reporting

Technical

  • 4+ years of experience with:
  • SAS
  • SQL
  • Snowflake

Business Analysis

  • 3+ years of business analysis experience.

Additional

  • Experience modernizing SAS ETL workflows into Snowflake.
  • Experience with:
  • Snowpark Python
  • Automated Data Pipelines
  • Cloud Data Platforms
  • ASP/ASP.NET experience is a plus.

Technical Skills

Data Engineering

  • Data Integration
  • ETL/ELT Development
  • Data Warehousing
  • Data Modeling
  • Data Quality Frameworks

Programming

  • SAS
  • SQL
  • Snowflake SQL
  • Snowpark Python
  • Python

Healthcare Analytics

  • Risk Adjustment
  • CMS Data Requirements
  • Encounter Data Processing
  • Claims Analytics
  • Provider Analytics
  • Enrollment Management

Cloud & Modern Data Platforms

  • Snowflake
  • Cloud Data Architecture
  • Pipeline Automation
  • Stream Processing
  • Workflow Orchestration

Analysis & Reporting

  • Data Validation
  • Reconciliation
  • Ad-Hoc Reporting
  • Trend Analysis
  • Financial Impact Analysis

Preferred Certifications

  • SAS Certified Professional
  • SAS Certification
  • SnowPro Certification


Core Competencies

  • Business Technical Analysis
  • Risk Adjustment
  • Medicare Advantage
  • Medicaid
  • Healthcare Analytics
  • SAS Programming
  • SQL Development
  • Snowflake
  • Snowpark Python
  • Data Engineering
  • ETL/ELT
  • Data Quality
  • Regulatory Compliance
  • CMS Reporting
  • Technical Documentation
  • Stakeholder Management
  • System Analysis
  • Technical Leadership

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