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Risk Adjustment Analyst Jobs (NOW HIRING)

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare ...

PacificSource

Senior Risk Adjustment Analyst

Bend, OR · On-site

The Senior Risk Adjustment (RA) Analyst assists in the accurate and comprehensive data submission to regulatory entities such as the Centers for Medicare & Medicaid Services (CMS) for all risk ...

PacificSource

Senior Risk Adjustment Analyst

Bend, OR · On-site

The Senior Risk Adjustment (RA) Analyst assists in the accurate and comprehensive data submission to regulatory entities such as the Centers for Medicare & Medicaid Services (CMS) for all risk ...

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How much do risk adjustment analyst jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for 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.

What are the typical daily responsibilities of a Risk Adjustment Analyst in a healthcare organization?

A Risk Adjustment Analyst’s daily responsibilities often include analyzing claims and clinical data to identify discrepancies, ensuring accuracy in diagnosis coding, and preparing reports that help forecast patient risk. They collaborate closely with coding teams, clinicians, and data managers to validate information and resolve any data quality issues. Additionally, they may participate in quality audits, provide guidance on documentation best practices, and stay updated on evolving regulatory requirements. This role requires a balance of technical analysis and cross-functional teamwork, making it both dynamic and impactful within the organization.

What does a Risk Adjustment Analyst do?

A Risk Adjustment Analyst reviews healthcare data to ensure accurate risk assessments for insurance plans. They analyze medical records, claims data, and coding practices to identify gaps or inaccuracies in risk adjustment reporting. Their work helps healthcare organizations optimize reimbursement and comply with regulatory requirements. Strong analytical skills, knowledge of risk adjustment models, and proficiency in medical coding (ICD-10, HCC) are essential for this role.

What are the key skills and qualifications needed to thrive in the Risk Adjustment Analyst position, and why are they important?

To thrive as a Risk Adjustment Analyst, you need strong analytical skills, a solid understanding of healthcare data, and typically a degree in health information management, statistics, or a related field. Experience with risk adjustment software, coding systems like ICD-10, and proficiency in data analysis tools (such as SQL or SAS) are highly valuable. Attention to detail, effective communication, and problem-solving abilities are essential soft skills for collaborating across functions and conveying complex findings. These skills enable accurate risk scoring, support regulatory compliance, and improve overall healthcare outcomes.

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Risk Adjustment Analyst jobs near you
Infographic showing various Risk Adjustment Analyst job openings in the United States as of July 2026, with employment types broken down into 78% Full Time, and 22% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $84,210 per year, or $40.5 per hour.
Risk Adjustment Analyst

Risk Adjustment Analyst

Centrum Health

Doral, FL • On-site

Other

Posted 14 days ago

Job description

SCOPE OF ROLE 

The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.

This is an onsite position in Doral, FL.

ROLE RESPONSIBILITIES

  • Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
  • Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.
  • Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
  • Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output.  Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
  • Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
  • Create data processes that are consistent, repeatable, and scalable.
  • Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor's degree is required.
  • Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
  • Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
  • Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
  • Three (3) or more years of analytics experience (Required)
  • Two (2) or more years of Power BI experience (Required)
  • Experience with Databricks (Preferred)
  • Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
  • Familiarity with HEDIS and MSSP Quality Reporting

PROFESSIONAL COMPETENCIES

  • Expertise in analytics, statistics, data visualization, or programming
  • Dedicates exacting attention to detail and data quality
  • Eager learner, collaborative partner, easy communicator, and careful analyst
  • Passion for empirical research and answering hard questions with data

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