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Risk Adjustment and Public Reporting Analyst

Carle Health

Job Location:

Champaign, IL - USA

Monthly Salary: Not provided by the employer

Posted: 26 July 2026 (30+ days ago)

Application Deadline: 23 October 2026

Vacancies: 1 Vacancy

Job Summary

Overview

The Risk Adjustment and Public Reporting Analyst is responsible for ensuring the accuracy and validity of risk adjustment methodologies and public reporting readiness. This role involves auditing analyzing and validating clinical and administrative data that influence risk-adjusted quality outcomes. The Analyst will collaborate closely with clinical departments coding teams and quality management to identify documentation gaps and support compliance with evolving regulatory standards.

Responsibilities

Risk Adjustment & Public Reporting Analyst (RAPRA): Owns risk-adjustment validity and public reporting readiness including audits tied to methodology coding/documentation impact and regulatory/program change tracking across CMS/Vizient/public Risk Adjustment and Public Reporting Analyst is responsible for proactively auditing analyzing and validating clinical and administrative data that drive riskadjusted quality outcomes and publicly reported role ensures the accurate representation of patient acuity organizational performance and compliance with evolving regulatory and methodological standards across CMS Vizient and other public reporting audit data elements that align with risk adjustment methodoligiesSupport analysis and reporting for CMS and other public reporting programs (e.g. Care Compare Star Ratings Leapfrog U.S. News where applicable)Responsible for exporting analyzing variations outliers and opportunity areas and distributing reports form the CMS Hospital Quality Reporting ProfileDevelop reports to support deliverables for a variety of closely with PI Specialist to present findings at opportunity review meetingsAnalyze and validate riskadjusted quality measures to ensure accurate representation of patient acuity and organizational performanceEvaluate the impact of documentation coding and comorbidity capture on riskadjusted outcomes (e.g. mortality complications readmissions)Collaborate with CDI and Coding teams to identify gaps affecting risk adjustment and quality outcomesPerform caselevel and populationlevel analyses to support appeals exclusions and methodological reviewsSupport analysis and reporting for CMS and other public reporting programs (e.g. Hospital Compare Star Ratings Leapfrog U.S. News where applicable)Assess the impact of risk adjustment methodologies on publicly reported outcomesTrack methodological updates and measure changes affecting public reporting programs

Qualifications

Certifications: IHI Open School Basic Certificate in Quality and Safety within 1 year - Institute for Healthcare Improvement (IHI). Medical Terminology within 1 year. Certification provided by Carle Health.

Education: Bachelors Degree: Related Field

Carle Health Company Overview

Find it here.

Discover the job the career the purpose you were meant for. At Carle Health were committed to fostering a workplace where every team member feels valued respected and empowered where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

Our nearly 17000 team members and providers work together to support patient care across central and southeastern Illinois. Weve grown to include eight award-winning hospitals and a multispecialty provider group with more than 1500 doctors and advanced practice providers. Were developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine the worlds first engineering-based medical school and Methodist College. Carle BroMenn Medical Center Carle Foundation Hospital Carle Health Methodist Hospital Carle Health Proctor Hospital Carle Health Pekin Hospital and Carle Hoopeston Regional Health Center hold Magnet designations the nations highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race color sex age national origin religion sexual orientation gender identity status as a veteran and basis of disability or any other federal state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and if necessary the Department of Homeland Security with information from each new employees Form I-9 to confirm work authorization. For more information:

Salary Range

The compensation range for this position is $31.32per hour - $53.87per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including but not limited to the candidates experience qualifications location training licenses shifts worked and compensation model.

Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit

Required Experience:

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