Risk Adjustment Consulting, Senior

Your Role 

The Risk Adjustment Prospective Program team focuses on transforming health care by making it more accessible, affordable and customer centric. The Risk Adjustment Consulting, Senior will report to the Senior Manager of Risk Adjustment. 

In this role you will provides essential support to the Prospective Programs (In-Home Visit) within the Risk Adjustment Prospective Program (ProsPr) team.  This includes interaction within the Risk Adjustment team, with various cross-functional teams within Blue Shield, Blue Shield IPA/MG and working directly with our vendors supporting our prospective programs.  The ideal candidate possesses excellent interpersonal skills, project management skills, organizational skills, has high attention to detail, and is self-motivated. The candidate will also possess a desire to continually learn.
 

Your Work 

In this role, you will: 

• Analyze information for core principles and functionality of decision, descriptive and predictive analytic methods including forecasting, statistical and machine learning techniques  
• Train lower-level analysts on how to update and apply these advanced analytic techniques
• Contribute to successful programs for the team, engaged multiple areas related to vendor oversight, internal cross-functional partnerships, tracking performance and measuring results
• Lead data analysis, documenting and verifying the assumptions used in computations such as those used in member risk data and score submissions and establishing revenue accruals  
• Manage the development and implementation of process of company's projects involving departmental or cross-functional teams focused on delivery of new or existing internal/external programs and/or products
• Facilitate the In-Home Visit (IHV) program from start to finish
• Work with internal and external teams on all aspects of the IHV program and monitors vendor performance to ensure alignment
• Gather and communicate information clearly in both in-person and virtual meetings
• Manage projects and timelines to achieve positive results
• Be able to provide backup support when asked upon

• Handle special projects as assigned.

  
   

Your Knowledge and Experience 

• Requires a college degree or equivalent experience 
• Requires a minimum of 4 years of prior relevant experience 
• Requires proficiency in Excel, Word, PowerPoint, and Outlook
• Requires previous project/program management experience 
• Requires strong communication and presentation skills 

• Vendor management or Provider-facing experience preferred

   

   

Hybrid 

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.