Overview
Hybrid
Depends on Experience
Contract - W2
Job Details
Risk Adjustment Business Analyst | Hybrid | Grand Rapids, MI | Contract
Walker Healthforce is seeking a Risk Adjustment Business Analyst with 5-7+ years of experience in Grand Rapids, MI. This is a 9-month contract opportunity.
CORE REQUIREMENTS:
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
JOB SUMMARY:
bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ensure compliance with CMS guidelines, minimize audit risk, and contribute to accurate population health representation and financial performance. The ideal candidate will bring a strong foundation in interpreting complex risk adjustment models (e.g., CMS-HCC, V28), gathering and translating business requirements, and using data analytics to identify gaps and opportunities. In addition to supporting vendor oversight, quality improvement efforts, and internal audit preparedness, the analyst will coordinate coding projects internally and with third-party coding platforms, evaluate the results, and package those outcomes for submission. Success in this role demands cross-functional collaboration, critical thinking, and the ability to operate in a fast-paced, high-stakes environment. This engagement directly supports our organization’s ability to remain compliant, optimize RAF accuracy, and achieve sustainable reimbursement outcomes.
WHAT WE OFFER:
WHY WORK WITH WALKER?
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
Walker Healthforce is seeking a Risk Adjustment Business Analyst with 5-7+ years of experience in Grand Rapids, MI. This is a 9-month contract opportunity.
CORE REQUIREMENTS:
- Must be local to Grand Rapids, MI
- Business Requirements Gathering: Interpret complex risk adjustment programs, initiatives, data, and relevant regulations, collaborate with stakeholders to gather and document business requirements for risk adjustment programs, translating them into functional specifications for technical teams.
- Reporting and Analytics: Develop and maintain reports to track key performance indicators (KPIs) related to risk adjustment coding and provide insights for decision-making. Utilize data analytics to identify potential data issues and proactively address them and assists with plans to implement effective compliance controls.
- Process Improvement: Analyze existing processes, identify areas for improvement, and develop strategies to enhance operational efficiency and accuracy in risk adjustment processes. Manage quality audits and reviews of clinical documentation and coding practices to support accurate risk adjustment. Assist with implementing and monitoring compliance controls, ensuring adherence to regulations and reducing the risk of non-compliance.
- Risk Adjustment Program Knowledge: Understanding of relevant risk adjustment programs, such as Medicare Advantage, and their specific compliance requirements
- Project Management: Ability to manage projects related to risk adjustment initiatives and compliance projects, requiring skills like defining scope, identifying resources, and scheduling.
- Stakeholder Management: Ability to collaborate effectively with various stakeholders, including clinical staff, IT teams, and management.
- Bachelor's degree in healthcare administration, business, data science, or a related field with strong quantitative and analytical coursework
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
- SQL Databricks experience
- Other relevant certifications: Depending on the specific role and focus, other certifications like the Certified Professional in Healthcare Information & Management Systems (CPHIMS), Certified Professional Medical Auditor (CPMA), or certifications related to specific risk adjustment models (e.g., Medicare Advantage) may also be preferred or beneficial.
- CRC certified
JOB SUMMARY:
bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ensure compliance with CMS guidelines, minimize audit risk, and contribute to accurate population health representation and financial performance. The ideal candidate will bring a strong foundation in interpreting complex risk adjustment models (e.g., CMS-HCC, V28), gathering and translating business requirements, and using data analytics to identify gaps and opportunities. In addition to supporting vendor oversight, quality improvement efforts, and internal audit preparedness, the analyst will coordinate coding projects internally and with third-party coding platforms, evaluate the results, and package those outcomes for submission. Success in this role demands cross-functional collaboration, critical thinking, and the ability to operate in a fast-paced, high-stakes environment. This engagement directly supports our organization’s ability to remain compliant, optimize RAF accuracy, and achieve sustainable reimbursement outcomes.
WHAT WE OFFER:
- Competitive compensation package
- Weekly pay via Direct Deposit
- Medical, Dental & Vision available
- 401k options
WHY WORK WITH WALKER?
- Access to our top ranked team of recruiting and placement specialists
- Continuous, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.