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Lumeris Risk Adjustment Business Intelligence Analyst (REMOTE NATIONWIDE) in St. Louis, Missouri

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Risk Adjustment Business Intelligence Analyst (REMOTE NATIONWIDE)

Position Summary:

This position sits within the Risk Adjustment Department and analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences and drive actionable insights. Constructs forecasts, recommendations and strategic/tactical plans based on Risk Adjustment data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. May provide consultation to users and lead cross-functional teams to address business issues. May directly produce datasets and reports for analysis using system reporting tools. You will be equally capable at delivering thoughtful analytics as you will be at communicating and presenting data to internal and external stakeholders. This position will require someone that can think strategically and be innovative, work well across departments and able to deliver accurate and timely information under tight deadlines. Your work will enable Risk Adjustment team members and leaders to manage our business. This position will have no direct reports. Lastly, this position will not only be performing analysis, creation of reporting, and deep dive data requests, but will be expected to have a seat at the table when these reports are being conceptualized.

Job Description:

Key Roles & Responsibilities:

  • Accurate and timely delivery of Risk Adjustment analysis, creation of reporting, population targeting for programs, and Ad Hoc requests

  • Collaborative contributor that will partner with multiple departments to drive the delivery of requests, as well as, partner within the Risk Adjustment Team to help develop requirements

  • Able to take complex datasets and provide simple, focused analysis to Risk Adjustment Team

  • Transform common datasets into actionable lists to meet vendor, client, and/or internal stakeholder needs

  • Help steward Risk Adjustment projects across the organization

  • Read, interpret, and develop reporting & analysis from changes in CMS Policy as related to Risk Adjustment. A yearly examination & subsequent report will be required to analyze the impact of such policy/program changes

  • Supports ensuring the integrity and accuracy of Risk Adjustment data

  • Assist with creation of Tableau, Excel, SQL, etc… reporting and dashboards

Experience, Qualifications, & Education

  • 5 plus years in a Health Plan, Vendor or Health System Operations performing similar functions

  • Bachelor’s degree is preferred

  • Understanding of Medicare Risk Adjustment (HCC) required, additional general understanding of Medicaid & Commercial Risk Adjustment preferred

  • Excellent problem solving, issue resolution, and root cause analysis skills

  • Self-Starter and able to work both collaboratively across teams and independently

  • Comfortable dealing with ambiguity

  • Experience creating and presenting client deliverables

  • Consistent experience creating actionable reports and analysis from multiple data sources

Working Conditions

  • While performing the duties of this job, the employee works in normal office working conditions.


  • The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.


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Time Type:

Full time

Join Our Growing Team!

Lumeris is a value-based care managed services operator for health systems and providers seeking extraordinary clinical and financial outcomes. Lumeris aligns providers and payers across populations with technologies, processes, behaviors and information to achieve high-quality, cost-effective care with satisfied consumers — and engaged physicians.

Lumeris with Essence Healthcare, its inaugural client and learning laboratory with more than 60,000 Medicare members in Missouri and Illinois, has averaged a CMS rating of 4.5 Stars for the last ten years and produced the highest consumer and physician satisfaction scores in the industry along with significantly better clinical outcomes and lower costs. For more information, go to www.lumeris.com.

Why Join Lumeris?

At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.