Medicare Advantage Risk Adjustment Business Data Analyst

General Information

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Work Location: Los Angeles, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am-5:00pm PST, may require occasional weekend or evening hours Posted Date 06/10/2025 Salary Range: $76200 - 158800 Annually Employment Type 2 - Staff: Career Duration indefinite Job # 24863

Primary Duties and Responsibilities

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As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful department measurements used in both internal and external reporting.

You will:

• Ensure data quality and accuracy through rigorous assurance checks.
• Develop and maintain reports, from ad hoc requests to scheduled production reports.
• Write clear specifications and design data queries for healthcare performance measures.
• Apply technical expertise to gather requirements and translate them into effective reports and data integration projects.
• Manage complex data projects that require periodic updates on weekly, monthly, quarterly, or annual cycles.
• Collaborate closely with Decision Support Services and Health Outcome & Analysis teams to transition ongoing reports into production environments.
• Interpret and document detailed written and verbal specifications, ensuring a comprehensive understanding of data relationships across encounters, claims, membership, and provider databases.
• Develop or apply technical specifications for healthcare measures from organizations such as CMS, DHCS, NCQA, and others.
• Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting.

Salary Range: $76,200 - $158,800/annually

Job Qualifications

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We are seeking an analytical, self-directed, detail-oriented individual with:

• A Bachelor’s degree in an IT related field or equivalent experience
• A Master’s degree in related field, preferred
• 3-5+ years in healthcare IT experience, highly desired
• 3–5+ years of experience with Epic Clarity reporting
• 3–5 years of experience building and maintaining Tableau dashboards.
• Proven experience generating reports using healthcare data, with a focus on encounter/claims, membership, and provider datasets, required
• Solid understanding of common healthcare measurement frameworks and definitions, including Risk Adjustment HCC models from CMS, required
• Strong analytical and problem-solving capabilities.
• Ability to work independently with minimal supervision while managing priorities effectively.
• Excellent communication skills to engage with stakeholders across all levels and gather clear requirements.
• Demonstrated ability to set, track, and meet goals within established timelines.
• Proficient in SQL programming, particularly on MS SQL Server and Oracle platforms, required
• Familiarity with statistical methods and their application in data analysis, required
• Knowledge of data warehouse architecture, data structures, and best practices in reporting.
• Extensive understanding of healthcare industry standards, workflows, policies, procedures, and system environments.
• Strong metadata management skills with the ability to analyze complex datasets.
• Skilled in translating business questions and requirements into actionable reports, database views, and BI query objects.

As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.