Consultant, Informatics Risk Adjustment

Job description

HealthPartners is hiring a Informatics Risk Adjustment Consultant. The Informatics Consultant –supports the Health Plan’s risk adjustment operations by delivering trusted, prioritized, and compliant data insights that drive efficient workflows and improve risk score accuracy, while continuously refining processes through feedback. This role ensures the plan’s risk adjustment outputs are accurately represented in claims and encounter data , analytics, and reporting. The consultant serves as a bridge between the data/technology teams and risk adjustment operations, clinical/provider stakeholders, coding and chart review teams, and compliance/audit partners. The role enables informed, compliant, and actionable risk adjustment program, while maintaining strong governance, audit readiness, and organizational standards. ACCOUNTABILITIES : Risk Adjustment Strategy & Program Execution Diagnosis Accuracy, Clinical Validity & Documentation Integrity Encounter & Claims Data Quality (Core Health Plan Focus) Provider & Vendor Enablement (External-Facing Consulting) - Support planning and execution of annual risk adjustment initiatives (prospective, concurrent, and retrospective), aligned to pla...