Senior Risk Adjustment Analyst
Elevance Health•Atlanta, IN
•Hybrid
About The Position
The Senior Risk Adjustment Analyst is a high-impact individual contributor on Elevance's Medicare Advantage Risk Adjustment team, reporting directly to the Staff VP of Analytics/Decision Support. This role is responsible for conducting advanced data analysis, building and maintaining HCC performance reporting, supporting predictive modeling initiatives and monitoring vendor performance. The Sr. Analyst serves as a key analytical resource, translating complex data into actionable insights for both clinical and operational stakeholders.
Requirements
- Requires an BA/BS degree in Information Technology, Computer Science or related field of study and minimum of 5 years experience with multi platform, two or more BI applications and/or multiple Business Intelligence tools required; or any combination of education and experience, which would provide an equivalent background.
- Medicare Advantage or commercial Risk adjustment data analysis experience is a must have
- SQL experience strongly preferred
- Intermediate Excel experience preferred
Nice To Haves
- Power BI experience is nice to have
Responsibilities
- Design, develop, and maintain risk adjustment performance dashboards and reports using Power BI, Tableau, or equivalent tools to monitor KPIs
- Write and optimize complex SQL queries to extract, transform, and analyze large datasets from data warehouses and payer/provider data systems
- Support the development and validation of predictive models for HCC suspecting, risk score forecasting, and provider performance stratification
- Prepare and present analytical findings, trend analyses, and performance summaries to key internal stakeholders
- Mentor junior analysts and coordinators, providing guidance on analytical methods, data interpretation, and risk adjustment concepts
- Support cross-functional initiatives in quality, population health, provider engagement and finance as they relate to risk adjustment analytics
- Maintains active relationships with customers to determine business requirements, leads requirement meetings
- Proactively addresses customer issues, prepares alternatives and implements solutions
- Collaborates with engineers for creative ideas for supporting interactive content, analyzes and classifies complex change request and reviews and evaluates possible enhancements
- Identifies and manages risks and develops contingency plans
- Partners with business, architecture and infrastructure and oversees all service levels
- Develops and defines application scope and objectives, including impact to interfaces
- Analyzes and evaluates detailed business and technical requirements
- Mentors others on coding standards and performs code reviews
- Supervises others on developing application internals for usability, reliability and scalability requirements
- Ensures system testing is completed and meets the test plan requirements
- Coordinates integration activities with other IT to ensure successful implementation and support of project efforts
- Assesses current status and supports BI planning efforts
- Mentors and assists in training initiatives and performs estimates for costs and impacts
- Manages small to medium projects, potentially leading global projects
- Mentors and provides training, conducts vendor evaluations and manages pilots for Business Intelligence tool upgrades
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Senior
