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Risk Adjustment Analyst Jobs (NOW HIRING)

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets. * Optimize Risk Adjustment Factor improvements through external vendors. * Partner with the ...

EmblemHealth

Lead Risk Adjustment Data Analyst

New York, NY · On-site

$77K - $149K/yr

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 ...

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How much do risk adjustment analyst jobs pay per hour?

As of Sep 14, 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 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 as a risk adjustment analyst?

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 September 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 82% Physical, 4% Hybrid, and 14% Remote job distribution, with an average salary of $84,210 per year, or $40.5 per hour.

Lead Actuarial Analyst, MA Risk Adjustment

Chicago, IL • On-site

Strive Health
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Strive Healthexternal

$99K - $124K/yr

Full-time

Medical

Re-posted 17 days ago

Job description

What You'll Do

We are seeking a Lead Actuarial Analyst, MA Risk Adjustment to join our high-performing, insights-driven team. You will play a critical role in evaluating financial performance, uncovering areas of opportunity, and use your 3+ actuarial exam progress to help translate complex data into actionable strategies. Your work will directly influence how Strive supports patients, clinicians, and markets in achieving both clinical and financial success. (This position is internally titled Lead Analyst, Risk Adjustment Analytics). We offer a competitive Actuarial Study Program designed to help you succeed, including exam fee support, study resources, and rewards for passing exams and achieving actuarial credentials.

Essential Functions 

  • Translate RA performance data into clear financial insights (i.e. revenue impact, payment accuracy, ROI, forecasting). 
  • Analyze CMS data to identify areas of opportunity to increase operational efficiency. 
  • Interpret trends, model scenarios, and assess program and policy impacts. 
  • Enable data-driven decisions by linking operational performance to enterprise financial outcomes. 
  • Perform end-to-end reconciliation from submissions to CMS acceptance, RAF leakage, and implement controls. 
  • Develop business cases to assess opportunity, determine target metrics, and provide data driven insights to support investment decisions (i.e. staffing, tech, etc.). 
  • Prepare and deliver clear and concise reports, presentations, and recommendations to senior leadership, illustrating the findings and implications of analyses conducted. 

Who You Are 

  • A highly analytical problem-solver with a strong sense of ownership and intellectual curiosity. 
  • Able to manage a high volume of recurring and ad hoc deliverables without compromising quality. 
  • Comfortable navigating ambiguity and bringing structure to complex problems. 
  • An exceptional communicator who can translate technical findings into actionable business recommendations. 

Qualifications 

  • 4+ years of experience in risk adjustment analytics. 
  • 4+ years of experience analyzing MMR, MOR, MAO-004 and medical claims data. 
  • 3+ actuarial exams passed. 
  • High degree of proficiency in Microsoft Excel and SQL.  
  • Experience with PBI, Redshift, dbt docs is a plus. 
  • Bachelor's degree in a quantitative or health-related field (e.g., Economics, Public Health, Statistics, Health Services Research, Math, Finance). 

Annual Salary Range: $99,000 - $124,000. This position is also eligible for a target annual bonus of 10%

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