Business Analyst Sr

Risk Adjustment Business Analyst

Resource will be required to come onsite 1 time a week

This engagement requires a highly skilled Risk Adjustment Business Analyst who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs.

Required Experience:

• Should have solid understanding in risk assessments and auditing in Medicare Advantage.
• Build reports using the data that is available.
• Look at the reports and summarize if the reports are correct and check for accuracy.
• Business analysis - Tableau reporting - Combine workbooks in Excel.
• Diagnosis and coding - CMS - Medical records coding and reports.

Education:

• Bachelor's degree in healthcare administration, business, data science, or a related field with strong quantitative and analytical coursework.
• Certified Professional in Healthcare Information & Management Systems (CPHIMS), Certified Professional Medical Auditor (CPMA), or certifications related to specific risk adjustment models (e.g., Medicare Advantage) may also be preferred or beneficial.
• CRC certified.