Risk Adjustment Business Analyst

POSTED ON 9/16/2020 CLOSED ON 10/2/2020
Optum Hired Organization Address Tacoma, WA Full Time

Job Posting for Risk Adjustment Business Analyst at Optum


Risk Adjustment Business Analyst

Department: Risk Adjustment

Status: Regular Full-time, FLSA Exempt

Location: Tacoma, WA

Reports to: Director of Risk Adjustment


The Northwest Physicians Network (NPN) Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, initiatives, and data through the employment of business requirements gathering, project management techniques, business systems analysis, and reporting using a variety of reporting platforms, systems, sources, and data formats. The business analyst will work closely within the Risk Adjustment team to understand business requirements, project deliverables, technical solutions, and short-term objectives and long-term goals. They will collaborate with other business units on the program and project structures, data gathering and transformation methodology, and analytical standards to ensure reporting accuracy, data integrity, and process efficiency.


  • Develop and maintain knowledge of key performance indicators related to Medicare Risk Adjustment and Hierarchical Condition Categories (HCCs)
  • Gather and clearly define and communicate business requirements and project goals
  • Develop methods to support the access, storage, and reporting of data sets that result from project initiatives
  • Effectively visualize and communicate the risks, insights, patterns, and trends from complex and disparate reports and sources
  • Develop and conduct quality control audits and test requirements to ensure accuracy of data
  • Identify, correct, and/or assist in resolution of project and program risks
  • Collaborate directly with internal and external business units
  • Perform data scrubbing, troubleshooting, quality checking, and usability analysis to identify anomalies, which need to be addressed prior to delivery of program and initiative results
  • Other duties as assigned


  • High-level of knowledge of Microsoft software suite including Word, PowerPoint, Project, PowerPoint, Visio
  • Intermediate to Advanced skill level with Microsoft Excel
  • Understanding of medical terminology and familiarity with medical records
  • Ability to interact and communicate effectively with healthcare providers
  • Strong communication and meeting facilitation skills
  • Strong written skills (process documentation, software documentation, SBAR, etc.)
  • Ability to effectively manage time, prioritize work, multi-task across many assignments without reminders or prompting from management
  • Working knowledge of the provider-based healthcare industry and Risk Adjustment strongly preferred



 Degree and/or a professional certification (preferred)


Three years’ experience in healthcare industry or related field which includes direct or indirect work with public health certificate/coursework, claims management systems, EMR platforms, healthcare regulations, Risk Adjustment MA/HHS, project management, data visualization, or other clinical related background (preferred).


AHIMA Certified Health Data Analyst (CHDA) required within 1 year of employment

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