Healthcare Statistical Analyst I/II/III/IV – Risk Adjustment

LTHC

. Perform technical services within the actuarial or risk adjustment department supporting Health Plan operations .

Posted 11/6/2026full-timeRochester • New York • United StatesJuniorMid-Level💰 $62,400 - $142,322 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong analytical capabilities and proficiency in data analysis, modeling, and reporting to support Health Plan operations. Possesses expertise in SQL, SAS, and VBA, along with a solid understanding of health insurance and regulatory environments.

Highest-signal resume keywords

Data AnalysisSQL ProgrammingStatistical ModelingHealth Insurance KnowledgeProject Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data Mining TechniquesPredictive ModelingStatistical AnalysisFinancial ProjectionsClaims Experience AnalysisRisk Score AnalysisTrend AnalysisProcess ImprovementData Quality SupportVBA Programming

Soft Skills

Strong Analytical SkillsVerbal CommunicationWritten CommunicationInterpersonal SkillsCollaboration Skills

Tools & Technologies

Microsoft Office SuiteData WarehouseStatistical SoftwareData Mapping ToolsReporting Dashboards

Industry Keywords

Actuarial ScienceHealth Plan OperationsManaged CareRegulatory ComplianceValue Based Payment Programs

Tech Stack

Tools & technologies

SQLVBA

About the role

Key responsibilities & impact

Perform technical services within the actuarial or risk adjustment department supporting Health Plan operations
Monitor and maintain financial solvency through analysis of current data and environments and modeling of future events
Interact with internal and external partners and regulatory agencies
Monitor trends and communicate opportunities and data insights to applicable audiences
Provide statistical information and analysis to support leadership decision-making
Identify trends and use data mining techniques and advanced predictive models
Update existing and help create analyses related to benefit designs, claims experience, Value Based Payment programs, claims savings, and risk adjustment initiatives
Maintain reserve programs, pricing files, benefit relativity tables, trend analysis, risk score analysis, VBP and vendor financial settlements, and ROI work
Create and maintain appropriate technical, process, data model, data mapping, and training documentation
Develop financial, claims, risk score, trend, utilization, and savings projections
Estimate unpaid claim liabilities and identify savings opportunities
Compile and analyze data, support data quality, and provide recommendations
Develop process improvements using systems and software applications
Conduct analyses and communicate with other departments on initiatives
Reconcile Data Warehouse data with corporate financials or encounter submissions and develop corrective actions
Improve data capabilities and quality of department analysis and reporting
Review pricing against profitability targets and analyze complex data ecosystems for reporting and dashboards
Lead and support departmental projects and provide technical advice to management
Conduct exploratory, descriptive, and inferential data analysis using statistical and machine learning techniques
Represent the department on special projects and lead projects with cross-departmental stakeholders
Interpret regulatory changes and develop Health Plan impact analyses
Collaborate with senior leadership on corporate goals and strategic decision-making

Requirements

What you’ll need

Bachelor’s Degree in Math, Statistics, Economics, Medical Informatics, Actuarial Science or relevant field required
One (1) year of related experience preferred for Level I
Two (2) years related experience for Level II
Four (4) years of related experience for Level III
Six (6) years related experience for Level IV
Strong analytical skills
Strong verbal and written communication skills
Strong interpersonal and collaboration skills
Ability to prioritize, multitask, and maintain multiple simultaneous projects
Intermediate technical skills, including proficiency in Microsoft Office Suite
Programming skills in SQL, SAS, VBA, or similar programming language preferred
Understanding of health insurance, managed care, accounting principles, competitive markets, legislative environments, and regulatory issues for Level II
Ability to work independently and improve processes
Understanding of non-Actuarial functions and their impact on Health Plan operations and financials
Ability to perform complex modeling independently for Level III
Ability to recognize and automate repetitive tasks
Ability to communicate analytical findings at the appropriate level of detail
Experience leading projects or process improvement initiatives
Ability to write and communicate complex concepts
Advanced understanding of relevant non-Actuarial functions for Level IV
Advanced ability to independently communicate analytical findings
Ability to write, communicate, and present complex concepts to actuarial and non-actuarial audiences
Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time
Ability to travel across the Health Plan service region for meetings and/or trainings as needed

Benefits

Comp & perks

Group health and/or dental insurance
Retirement plan
Wellness program
Paid time away from work
Paid holidays
Potential remote work, decided case-by-case