Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for a Business Analyst for a contract opportunity with one of our largest clients located in Grand Rapids, MI!

Title: Business Analyst (Healthcare)
Location: Grand Rapids, MI (Hybrid/1 day per week onsite)
Duration: 12+ Months
Role Type: W2 Contract Engagement

Engagement Description

We are looking for a highly skilled Risk Adjustment Business Analyst who can 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.

Top Required Skills/Experience

• 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.
• 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.
• 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.

Preferred Skills/Experience

• 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

Education

• Bachelor's degree in healthcare administration, business, data science, or a related field with strong quantitative and analytical coursework

 *Beware of scams. S3 never asks for money during its onboarding process