Risk Adjustment Health Data Analyst
Nebraska Blue
- # Risk Adjustment Health Data AnalystApplyremote type: Hybridlocations: Remote flexibility for candidates in FL, IA, KS, MN, MO, NE, ND, or TXtime type: Full timeposted on: Posted 3 Days Agojob requisition id: JR101331At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.The Healthcare Analytics role supports the Risk Adjustment Programs team by analyzing healthcare data to evaluate program performance, measure financial and clinical impact, and identify opportunities for improvement. This role develops reporting, forecasts, and actionable recommendations that inform Risk Adjustment strategy, intervention planning, and operational decision-making.**Candidates applying to this position may be hybrid or remote and can live in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.****What you'll do:*** Analyze healthcare claims, pharmacy, lab, and Risk Adjustment submissions data to evaluate intervention and program performance.* Develop, maintain, and present reports that measure intervention ROI, incremental conditions captured, risk score impact, revenue impact, and other key Risk Adjustment performance metrics.* Partners with internal teams to support Risk Adjustment analytics needs, intervention planning, reporting enhancements, and issue resolution.* Stay current on healthcare analytics, Risk Adjustment trends, tools, methodologies, and regulatory considerations; recommend process or reporting improvements where appropriate.* Provide analytic solutions on ad-hoc requests with little oversight by senior analysts.**To be considered for this position, you must have:*** Bachelor’s degree or equivalent* 3+ years’ experience in data or statistical analysis, or experience with managing and analyzing data for Government programs (Medicare Advantage, Commercial ACA) including experience working with healthcare-related data, such as claims, encounters, provider data, CMS files, EDGE response files, or similar datasets.* Proficiency in SQL and data analytics.* Experience with Microsoft Azure DataBricks.* Advanced Excel skills.* Strong analytic skills to construct impactful findings from the extraction, manipulation and understanding of various types of data.* Successful experience working in a cross-functional environment.* Experience effectively communicating with stakeholder groups.**The strongest candidates for this position will also possess:*** Proficiency working within an environment that utilizes Agile and/or Project Management techniques.* Successful experience with creating analytic models based on data trends, business program ROI, data Quality Analysis, etc.* The translation of data findings into informative reports and visual outputs trusted by stakeholders to make business decisions.* Experience designing or building self-service content.* Advanced SQL knowledge.* Understanding of Health Insurance Operations knowledge including claims, enrollment, payment mechanisms, care management, employer reporting and the ability to stay current on healthcare industry knowledge.* Strong knowledge of the MA risk adjustment models, concepts, payment methodologies and submission requirements.* Ability to use advanced-level calculations in the transforming of data sets into usable data.* Ideal candidate would have experience using data manipulation tools such as R and/or Python.* Proficiency of visualization best practices as well as Proficiency with visualization tools such as PowerBI and/or Tableau.* Experience with Microsoft Azure DataBricks.* Ability to translate technical requirements into business deliverables.* Skilled in navigating relationships with external partners such as vendors, providers, groups, brokers, etc.* Master's Degree in Business, Analytics, Information Technology or a Related Field.Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.*We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.*
- J-18808-Ljbffr Nebraska Blue
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Risk Adjustment Health Data Analyst in Kansas City, MO vacancy
- Nebraska Blue Cross and Blue Shield is seeking a Risk Adjustment Health Data Analyst to join our Healthcare Analytics team. You will analyze claims, enrollment, and risk adjustment submissions to evaluate program performance and identify opportunities for improvement. The...RiskRemote job
- ...Healthcare Analytics role supports the Risk Adjustment Programs team by analyzing healthcare data to evaluate program performance,... ...with little oversight by senior analysts. To be considered for this... ...knowledge. Understanding of Health Insurance Operations knowledge including...RiskLive inRemote work
$2,500 per month
The Data Analyst for Value-Based Insights (VBI) is responsible for transforming Medicare (CMS... ...power WellSky's VBI product for Home Health and Hospice providers and payers. This... ...Tableau, or Power BI.Familiarity with risk adjustment or benchmarking concepts.Scripting experience...RiskFull timeWork experience placement$105.4k - $207.8k
...compliance, and protect critical data. As part of this team, you... ...environments.Performing technical health checks, discovery, and... ...strengthen security posture and reduce risk. A successful candidate would... ...range estimate has not been adjusted for the applicable geographic...RiskLocal areaVisa sponsorship$109k - $171k
...motivated and autonomous Senior Data Analyst to join our team. In this... ...who is comfortable taking risks. Know how and when to apply... ...with company match Mental health resources including Headspace... ...market and industry data and is adjusted to reflect the cost of living...RiskRemote workWork from homeWork visaGrabJobs
Kansas City, MO4 days ago- We are looking for a Data Security Analyst to join our Information Security Architecture team in Philadelphia... ...Posture Management (DSPM) or Insider Risk toolsExperience supporting data leakage... ...in your time zone, with flexibility to adjust to various global time zones as...RiskFull timeWork at office2 days per week
- ...user training, system updates, and platform health Improve tool reliability, usability, and... ...and reviews Identify compliance gaps, risks, and follow-up actions Oversee SharePoint... ...and resource management reporting Maintain data quality, reporting consistency, and stakeholder...RiskRelocationRelocation package
- Blue Cross NC is seeking a Consulting Actuary - ACA Risk Adjustment to lead pricing strategies, assess models, benchmark competitors, and design sophisticated insurance products. The role requires strong actuarial credentials and extensive experience in ACA risk adjustment...Risk
$70.1k - $126.2k
...million members. Centene is transforming the health of our communities, one person at a time.... .... Perform periodic compliance audits, risk assessments and conducts related to... ...office work schedules Actual pay will be adjusted based on an individual's skills, experience...RiskFull timeContract workPart timeInterim roleWork at officeRemote workWork from homeFlexible hours$148.2k - $292.3k
...engagements spanning the entire health care landscape and product... ...predictive modeling, underwriting, and risk analysis methodologies to... ...cutting-edge technology, data, and a blend of deep technical... ...years of experience with risk adjustment mechanisms, group insurance products...RiskLocal areaVisa sponsorship- Saint Luke’s Health System in Kansas City, MO is seeking an Information Security Governance, Risk & Compliance Analyst II to ensure IT processes meet defined security controls and to perform vulnerability analyses and risk assessments. The role leads security reviews, conducts...Risk
$148k - $274.2k
...million members. Centene is transforming the health of our communities, one person at a time.... ...within Enterprise Privacy & Security Risk Management (EPSRM). Work with other Shared... ...work schedules. Actual pay will be adjusted based on an individual's skills, experience...RiskFull timeContract workPart timeWork at officeRemote workFlexible hours$87.7k - $157.8k
.... Centene is transforming the health of our communities, one person... ...impacting operations, systems, and data, and maintain awareness of... ...stakeholders, delivering risk‑informed insights, recommendations... ...schedules. Actual pay will be adjusted based on an individual’s skills...RiskFull timePart timeWork at officeRemote workFlexible hours- Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical... ...partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts...Risk
- We're Looking for an experienced Senior Data Governance Analyst — Unstructured Data & AI Readiness!... ...Ward’s 50 list of top-performing life-health insurance companiesRecognized on list of... ...Gen AI & Innovation team and enterprise Risk function to provide governance inputs into...RiskFull timeTemporary workRemote workFlexible hours
$220k - $330k
...recommendations and steering actions that improve the risk-adjusted performance and resilience of the... ..., working directly with underwriting data in Palantir and other analytical... ...cover both Property & Casualty and Life & Health. Combining experience with creative thinking...RiskTemporary workWork at officeRelocation packageFlexible hours3 days per weekSwiss Re
Kansas City, MO1 day ago$1,796 per week
...their progress and responding to changes in health status. The RN will work collaboratively... ...for intervention. Identify potential risks and complications, such as arrhythmias,... ...and other continuous monitoring devices, adjusting care as necessary. Provide post-surgical...RiskFull timeContract workShift workMagnet Medical
Overland Park, KS1 day ago$725 per month
...programs catered to your overall health and wellness. Full suite of health... ...of associates, reducing legal risks and ensuring regulatory compliance... ...analysis to review local market data and partner with the Compensation COE on adjustments and make recommendations based on...RiskHourly payFull timeTemporary workPart timeLocal areaFlexible hoursShift workNight shiftAfternoon shiftBrookdale
Kansas City, KS2 days ago- ...Data AnalystThe Office of Fleet Management manages vehicle acquisition, utilization, and... ...without transportation delays.As a Data Analyst in the Office of Fleet Management, you will... ...platforms to identify trends, patterns, risks, and opportunities. Develops dashboards...RiskWork at office
General Services Administration
Kansas City, MO9 hours ago $90k - $120k
...Data Analyst Location: Remote (U.S.) Compensation: $90K – $120K Team: Engineering Level: Intermediate... ...data analysis to uncover trends, risks, and growth opportunities. Define and... ...Raised a $80M Series B funding in Feb 2026 Health/Dental/Vision insurance (premiums...RiskRemote workGrabJobs
Kansas City, MO4 days ago$2,701 per week
...their progress and responding to changes in health status. The RN will work collaboratively... ...for intervention. Identify potential risks and complications, such as arrhythmias,... ...and other continuous monitoring devices, adjusting care as necessary. Provide post-surgical...RiskFull timeContract workFlexible hoursShift workTravelNurseSource
Kansas City, MO1 day ago- ...experience / knowledge in the areas of safety and risk management recommended. Fleet Safety and... ...to drive as outlined in the Betacom Health, Safety and Environmental Policy Manual’s... ..., depth perception, and the ability to adjust focus. • Estimated travel minimal...RiskFor subcontractor
Betacom
Kansas City, MO15 days ago - ...Senior Data AnalystAt MMGY Global, we believe nothing shapes your view of the world like... ...an immediate opening for a Senior Data Analyst in our Overland Park, KS office.As a key... ...internal deadlines, proactively flagging risks and managing expectations with minimal oversight...RiskSeasonal workWork at officeImmediate startRemote work
MMGY Global
Overland Park, KS3 days ago $87.7k - $157.8k
.... Centene is transforming the health of our communities, one person... .... Confer with staff to obtain data such as new projects, status of... ...in quality improvement, risk management, or another parallel... ...schedules Actual pay will be adjusted based on an individual's skills...RiskFull timePart timeH1bWork at officeRemote workWork from homeFlexible hours$1,936 per week
..., according to protocols. Monitor and adjust invasive monitoring devices such as arterial... ...on the recovery process, cardiac health, medications, lifestyle modifications, and... ...safe environment for patients, reducing the risk of hospital-acquired infections. Emergency...RiskFull timeContract workImmediate startShift workNight shiftMagnet Medical
Kansas City, MO1 day ago- ...in Overland Park, KS is seeking a Pre-Underwriting Analyst I to coordinate gathering financial documents in... ...Documentation Policy. You will support the Credit & Risk team, maintain customer files, and deliver accurate data with strong analytical skills. The role emphasizes...Risk
$105.4k - $207.8k
...interested in improving the cyber and organizational risk profiles of leading companies? Do you want to build the data foundations that power the next generation of AI... .... The disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaVisa sponsorship- ...Risk Management SpecialistThe Risk Management Specialist oversees the event management system for the Health System-Kansas City Division. Participate in the development, implementation,... ...responsible for ensuring event management data is available to leaders to assist in...RiskWork at officeWork from home
The University of Kansas Health System
Kansas City, KS3 days ago - Saint Luke's Health System in Kansas City, MO seeks a senior leader to direct the Risk Management Program and oversee the Patient Advocate Department. This role protects the organization's assets by proactively reducing adverse events and guiding leadership. The ideal candidate...Risk
$1,936 per week
..., according to protocols. Monitor and adjust invasive monitoring devices such as arterial... ...on the recovery process, cardiac health, medications, lifestyle modifications, and... ...safe environment for patients, reducing the risk of hospital-acquired infections. Emergency...RiskFull timeContract workImmediate startFlexible hoursShift workNight shiftTravelNurseSource
Kansas City, MO1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Risk Adjustment Health Data Analyst. Be the first to apply!
Related searches
- third party risk analyst Kansas City, MO
- senior quantitative risk analyst Kansas City, MO
- it risk analyst Kansas City, MO
- operational risk consultant Kansas City, MO
- risk officer Kansas City, MO
- risk analyst Kansas City, MO
- operational risk specialist Kansas City, MO
- risk consultant Kansas City, MO
- information systems analyst Kansas City, MO
- data solutions analyst Kansas City, MO