Senior Risk Adjustment Analyst

Location: Norfolk VA, Mason OH, Indianapolis IN, Louisville KY, Grand Prairie TX, Tampa FL, Atlanta GA

Hours: Standard Working hours

Travel: This role requires associates to be in‑office 1 – 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Senior Risk Adjustment Analyst is a high‑impact individual contributor on Elevance's Medicare Advantage Risk Adjustment team, reporting directly to the Staff VP of Analytics/Decision Support. This role is responsible for conducting advanced data analysis, building and maintaining HCC performance reporting, supporting predictive modeling initiatives and monitoring vendor performance. The Sr. Analyst serves as a key analytical resource, translating complex data into actionable insights for both clinical and operational stakeholders.

• Design, develop, and maintain risk adjustment performance dashboards and reports using Power BI, Tableau, or equivalent tools to monitor KPIs
• Write and optimize complex SQL queries to extract, transform, and analyze large datasets from data warehouses and payer/provider data systems
• Support the development and validation of predictive models for HCC suspecting, risk score forecasting, and provider performance stratification
• Prepare and present analytical findings, trend analyses, and performance summaries to key internal stakeholders
• Mentor junior analysts and coordinators, providing guidance on analytical methods, data interpretation, and risk adjustment concepts
• Support cross‑functional initiatives in quality, population health, provider engagement and finance as they relate to risk adjustment analytics
• Maintain active relationships with customers to determine business requirements, lead requirement meetings, proactively address customer issues, prepare alternatives and implement solutions
• Collaborate with engineers for creative ideas for supporting interactive content, analyze and classify complex change requests and review and evaluate possible enhancements
• Identify and manage risks and develop contingency plans
• Partner with business, architecture and infrastructure teams and oversee all service levels
• Develop and define application scope and objectives, including impact to interfaces
• Analyze and evaluate detailed business and technical requirements
• Mentor others on coding standards and perform code reviews
• Supervise others on developing application internals for usability, reliability and scalability requirements
• Ensure system testing is completed and meets the test plan requirements
• Coordinate integration activities with other IT to ensure successful implementation and support of project efforts
• Assess current status and support BI planning efforts
• Mentor and assist in training initiatives and perform estimates for costs and impacts
• Manage small to medium projects, potentially leading global projects
• Mentor and provide training, conduct vendor evaluations and manage pilots for Business Intelligence tool upgrades

• Requires a BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 5 years experience with multiple BI applications and/or Business Intelligence tools; or any combination of education and experience, which would provide an equivalent background.

• Medicare Advantage or commercial risk adjustment data analysis experience is a must have
• SQL experience strongly preferred
• Intermediate Excel experience preferred
• Power BI experience is nice to have

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for…