Senior Risk Adjustment Analyst

You spend most weeks between claims data, encounter submissions, and risk-score calculations — analyzing member-level risk scores, supporting CMS or state submissions, investigating documentation gaps, mentoring junior analysts on technical work. You're often at the intersection of healthcare-data analysis and CMS submission requirements. Submission accuracy and risk-score outcomes anchor the visible measures.

Where it gets demanding is the CMS-attention exposure of risk-adjustment work — RADV audits, accuracy expectations, and the multi-year impact of submission decisions. Variance across employers is sharp: at major health insurers senior risk-adjustment analysts work within structured CMS-compliant programs; at growth-stage health plans the senior analyst often shapes program direction directly.

It fits people who are analytically deep, regulatorily fluent, and patient through CMS-submission cycles. The trade-off is the audit-attention exposure typical of senior risk-adjustment work. Healthcare-data credentials and CMS-program training anchor advancement.