Risk Adjustment and Public Reporting Analyst

Risk Adjustment and Public Reporting Analyst Overview The Risk Adjustment and Public Reporting Analyst is responsible for ensuring the accuracy and validity of risk adjustment methodologies and public reporting readiness. This role involves auditing, analyzing, and validating clinical and administrative data that influence risk-adjusted quality outcomes. The Analyst will collaborate closely with clinical departments, coding teams, and quality management to identify documentation gaps and support compliance with evolving regulatory standards. Qualifications Certification: IHI Open School Basic Certificate in Quality and Safety within 1 year (Institute for Healthcare Improvement) Bachelor’s Degree in a related field Relevant work experience Responsibilities Owns risk-adjustment validity and public reporting readiness, including audits tied to methodology, coding/documentation impact, and regulatory/program change tracking across CMS, Vizient, and public programs. Proactively audits data elements that align with risk adjustment methodologies. Supports analysis and reporting for CMS and other public reporting programs (e.g., Care Compare, Star Ratings, Leapfrog, U.S. News). Exports, analyzes variations, outliers, and opportunity areas and distributes reports from the CMS Hospital Quality Reporting Profile. Develops reports to support deliverables for stakeholders. Works closely with PI Specialist to present findings at opportunity review meetings. Analyzes and validates risk-adjusted quality measures to ensure accurate representation of patient acuity and organizational performance. Evaluates the impact of documentation, coding, and comorbidity capture on risk-adjusted outcomes (e.g., mortality, complications, readmissions). Collaborates with CDI and Coding teams to identify gaps affecting risk adjustment and quality outcomes. Performs case-level and population-level analyses to support appeals, exclusions, and methodological reviews. Assesses the impact of risk adjustment methodologies on publicly reported outcomes. Tracks methodological updates and measure changes affecting public reporting programs. Compensation and Benefits The compensation range for this position is $31.32 per hour - $53.87 per hour. This represents a good‑faith minimum and maximum range at the time of posting by Carle Health. The actual compensation offered to a candidate will be dependent on factors including experience, qualifications, location, training, licenses, shifts worked, and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. Visit to learn more. Equal Opportunity Employer We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, or basis of disability or any other federal, state or local protected class. Carle Health participates in E‑Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee’s Form I‑9 to confirm work authorization. For more information: View email address on click.appcast.io. #J-18808-Ljbffr Carle Health