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Radv Business Analyst

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Robert Half

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Location:
United States , Eden Prairie

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Category:
IT - Software Development

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Contract Type:
Employment contract

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Salary:

Not provided
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Job Description:

We are looking for a business process analyst to support Risk Adjustment Data Validation activities within a highly regulated health insurance environment. This long-term contract position focuses on strengthening audit operations through careful review of member, enrollment, and claims-related information while helping maintain compliance and reporting accuracy. Based in Minnesota, but able to work fully remote, this opportunity is well suited for a detail-focused analyst who can manage complex data issues, coordinate with cross-functional partners, and contribute to successful audit execution in a remote work setting.

Job Responsibility:

  • Manage and refine Excel-based trackers, audit logs, and supporting documentation to keep project records accurate and current
  • Examine demographic, eligibility, and enrollment information to identify errors, confirm completeness, and support audit preparedness
  • Assess medical, pharmacy, and claims records to verify that submitted data aligns with required standards and supporting evidence
  • Analyze reporting results to detect omitted or conflicting diagnosis details that may affect Hierarchical Condition Category outcomes
  • Investigate data inconsistencies across multiple sources, resolve issues when possible, and elevate critical risks or obstacles to leadership in a timely manner
  • Prepare recurring project updates that summarize progress, open issues, and milestone status for stakeholders
  • Partner with internal teams and external vendors to coordinate deliverables and maintain momentum against audit timelines
  • Apply current CMS guidance, audit protocols, and privacy requirements when handling sensitive healthcare information
  • Participate in project and cross-functional meetings, adjust to shifting priorities, and provide support for related operational initiatives as needed

Requirements:

  • At least 5 years of experience in the healthcare industry working with claims, membership, provider, or eligibility data
  • Minimum 5 years of business analysis or operational analysis experience in a structured, deadline-driven environment
  • Advanced ability to use Microsoft Excel for tracking, validation, reconciliation, and reporting activities
  • Strong understanding of audit support, compliance expectations, and data quality review within healthcare operations
  • Demonstrated skill in researching discrepancies, interpreting findings, and communicating resolutions clearly to stakeholders
  • Ability to work independently in a remote setting while collaborating effectively across multiple teams and time zones
  • Strong written and verbal communication skills, sound judgment, and the ability to manage multiple priorities with close attention to detail
What we offer:
  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan

Additional Information:

Job Posted:
May 03, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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