Risk Adjustment Healthcare Analyst III

JOB REQUIREMENTS: Description Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor responsible for delivering complex, high-impact analytics and reporting that supports the organization's Risk Adjustment strategy. This role translates healthcare and claims data into actionable insights that inform financial performance, coding accuracy, and regulatory compliance. Operating with minimal supervision, the analyst independently owns assigned analytics and reporting deliverables and serves as a trusted analytical resource to cross-functional partners including actuarial, finance, clinical, and operational teams. The role requires strong applied analytics expertise, solid understanding of CMS risk adjustment methodologies, and the ability to clearly communicate insights to diverse audiences. Key Accountabilities Risk Adjustment Analytics & Reporting Independently develop, maintain, and enhance complex risk adjustment reporting and analytic solutions, including HCC coding accuracy, RAF score performance, and financial impact analysis. Ensure outputs are accurate, timely, and aligned with business needs. Cross-Functional Partnership Collaborate closely with actuarial, finance, clinical, quality, and operational partners to support data-driven decision-making. Serve as an analytical resource by explaining results, assumptions, and implications of risk adjustment analytics. Data Quality & Validation Ensure the integrity, consistency, and reliability of risk adjustment data through established validation and reconciliation processes. Identify data quality issues, conduct root-cause analysis, and recommend corrective actions. Performance Monitoring & Insight Generation Monitor and analyze key risk adjustment performance indicators. Identify trends, variances, and anomalies, and proactively communicate findings and implications to stakeholders. Data Visualization & Communication Design and deliver dashboards and visualizations (e.g., Tableau, Power BI) that clearly communicate complex analytical findings to technical and non-technical audiences. Regulatory & Methodology Awareness Maintain working knowledge of CMS risk adjustment guidelines and model... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/2C735177062841EB