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Senior Risk Adjustment Data Analyst Jobs (NOW HIRING)

Medica

Risk Adjustment Healthcare Analyst

Madison, WI

$90K - $155K/yr

The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor responsible ... This role translates healthcare and claims data into actionable insights that inform financial ...

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How much do senior risk adjustment data analyst jobs pay per year?

As of Jun 8, 2026, the average yearly pay for senior risk adjustment data analyst in the United States is $109,846.00, according to ZipRecruiter salary data. Most workers in this role earn between $90,500.00 and $137,000.00 per year, depending on experience, location, and employer.

What does a Senior Risk Adjustment Data Analyst do?

A Senior Risk Adjustment Data Analyst is responsible for analyzing healthcare data to ensure accurate risk adjustment, which is crucial for determining appropriate payments to health plans. They identify data trends, validate medical coding, and work to ensure that diagnoses and procedures are properly documented and reported. These professionals collaborate with clinical and IT teams, provide insights to improve data quality, and help organizations comply with regulations. Their work supports fair reimbursement and helps improve patient care outcomes.

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

To thrive as a Senior Risk Adjustment Data Analyst, you need expertise in healthcare data analysis, risk adjustment methodologies, and a solid background in statistics or a related field—often supported by a bachelor's or master's degree. Familiarity with SQL, SAS, Python, and risk adjustment software platforms, as well as knowledge of CMS-HCC or HHS-HCC models, is typically required. Strong analytical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These competencies ensure accurate data interpretation, regulatory compliance, and impactful insights that drive optimal revenue and patient outcomes for healthcare organizations.

How does a Senior Risk Adjustment Data Analyst typically collaborate with clinical and IT teams?

A Senior Risk Adjustment Data Analyst frequently works cross-functionally with both clinical and IT teams to ensure accurate and compliant capture of risk adjustment data. They translate analytical findings into actionable insights for clinicians, helping to improve documentation and coding accuracy. Collaboration with IT is essential for streamlining data extraction processes, implementing new analytics tools, and safeguarding data quality. Regular meetings and project-based work are common, fostering a collaborative environment where communication skills and technical expertise are both highly valued.
Infographic showing various Senior Risk Adjustment Data Analyst job openings in the United States as of May 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $109,846 per year, or $52.8 per hour.
Risk Adjustment Data Analyst

Risk Adjustment Data Analyst

The Health Plan of West Virginia Inc

Wheeling, WV • On-site

Full-time

Posted 10 hours ago

Job description

Position Summary:

The Risk Adjustment Data Analyst will support The Health Plan’s risk adjustment management program with regard to risk adjustment models and guidance. This position will be involved in gathering, analyzing and reporting on data from multiple sources (e.g. member data, provider data, claims/enrollment processing, risk adjustment operations, analytical software and other resources) to extract trends and business insights to improve efficiencies and effectiveness of the risk adjustment management program.

Qualifications Required:

  1. College degree or a combination of education/experience in the health care industry.
  2. Computer experience with Microsoft Word, Excel, Power Point and Outlook
  3. Strong organizational, verbal and written communication skills balancing an independent and team working environment.
  4. Experience in data collection, analysis and visualization methods
  5. Previous work in a medical, managed care, or data driven organization(s).
  6. Ability to prioritize tasks in an environment with multiple (sometimes competing) priorities
  7. Experience with Microsoft SQL Server, MySQL and Power BI

Qualifications Desired:

  1. Proficient keyboarding skills and computer literacy with the ability to navigate through multiple systems
  2. Experience in a federally regulated environment
  3. Medical terminology
  4. Knowledge of ICD and CPT coding (prefer certification)
  5. Familiar with medical and hospital claims
  6. Possess a working knowledge of quality improvement principles, theory, study design and statistical modeling, forecasting and benchmarking.

Essential Functions and Responsibilities:

  1. Develop and analyze reporting to support risk adjustment management programs/operations.
  2. Supports reporting requirements as needed for governmental and accreditation processes.
  3. Assist with submission, monitoring, and error management of encounter data to the CMS, BMS, and the EDGE server in accordance with models and guidelines.
  4. Supports reporting to identify inefficiencies to develop modifications in processes currently being used within the risk adjustment management program.
  5. Interfaces with staff and providers to support overall risk adjustment management programs with reporting.
  6. Interfacing with, gathering information from and preparing data for presentations to various levels of management, committees, internal and external partners.
  7. Utilizes databases, analytical software programs, and reporting tools to extract data, generate reports, perform moderate to complex data analysis to identify trends within a population and potential for system/process improvement.
  8. Attend continuing education classes/seminars to maintain professional and technical knowledge of State/Federal requirements.

Non-Essential Functions

1. Perform other related duties as assigned.



8:00am - 5:00pm
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