Risk Adjustment Data Analyst
We are seeking a highly analytical, detail-oriented Risk Adjustment Data Analyst to support our Medicare Advantage, ACA, and other risk-based consulting and auditing programs. This role is central to our reporting, trend analysis, risk adjustment analytics, risk adjustment data validation, and opportunity targeting. The ideal candidate understands CMS risk adjustment methodologies across Medicare Advantage, ACA, and Medicaid, knows how coding data drives outcomes, and can turn data insights into actionable strategies for clients and internal teams. Experience with RADV audits and compliance is preferred. This is a 1099 independent contractor role: remote and project-based.
What You’ll Do
- Conduct comprehensive analysis of client outcomes data to uncover drivers, risks, and opportunities, and deliver executive-ready insights that inform strategic decisions.
- Apply risk adjustment methodologies to monitor performance, identify trends, generate recurring risk reports, and partner with cross-functional teams to identify and support improvement opportunities.
- Ensure data accuracy and reliability by profiling and reconciling datasets, resolving anomalies, and maintaining documented logic, lineage, and governance standards.
- Develop and maintain user-friendly dashboards and automated reports, standardizing key metrics and refresh schedules to support leaders and providers.
- Serve as a subject matter expert, translating complex analytical findings into clear, actionable insights for technical and non-technical stakeholders.
- Uphold HIPAA, CMS and state regulations, and governance standards by maintaining compliant, audit-ready processes and documentation.
- Enhance efficiency through automation, improved data pipelines, and evaluation of emerging tools that drive productivity and reusability.
Technical & Database Work
- Write and optimize SQL queries and stored procedures for data extraction, transformation, and analysis.
- Develop automated ETL workflows and data pipelines to support ongoing reporting needs.
- Work with large datasets in SQL Server and healthcare analytics platforms.
- Build dashboards and data visualizations using Power BI or SSRS.
- Use tools such as SQL Server, SSIS, Power BI, SSRS, Python, and Excel.
Collaboration
- Partner with client, vendor, and internal teams to interpret results and support program initiatives.
- Assist with regulatory and compliance-related reporting requirements.
- Present findings and insights to both technical and non-technical stakeholders.
Qualifications
- Bachelor’s degree in Data Analytics, Health Informatics, Statistics, Computer Science, or a related field.
- 2–5+ years of healthcare data analytics experience.
- Knowledge of Medicare Advantage and ACA programs, HEDIS, and/or CMS Star Ratings.
- Advanced SQL skills for querying and analyzing large datasets.
- Experience with BI tools such as Power BI, SSRS, or similar.
- Strong analytical, problem-solving, and communication skills.
Preferred Qualifications
- Experience working in Medicare Advantage and ACA organizations, MSOs, or managed care settings.
- Knowledge of HCC risk adjustment, RAF methodologies, capitation payment models, DOFR, claims processing, bid design, and CMS regulatory requirements.
- Familiarity with EDPS encounter data, claims submissions, and acceptance processes.
- Experience with ETL tools (e.g., SSIS) or programming languages such as Python or .NET.
About ATTAC Consulting Group
Founded in 2003, ATTAC Consulting Group is a national firm that health plans, providers, and regulators trust to deliver compliance, audit, and operational solutions that stand up to scrutiny and drive measurable results. ATTAC supports organizations across Medicare Advantage, Medicare Part D, Medicaid, Duals and LTSS, Commercial, and ACA lines of business through five integrated practice areas: Risk Adjustment, Auditing, Provider Networks, Compliance Solutions, and Business Transformation.
How to Express Interest
Send a brief introduction and your resume to acghumanresources@attacconsulting.com or submit the form.
