Demo

Risk Adjustment Consulting, Consultant

Blue Shield of California
Long Beach, CA Full Time
POSTED ON 2/6/2025
AVAILABLE BEFORE 4/6/2025

Job Details

Your Role

The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV) within the Risk Adjustment (Prospective Program) team. This includes interaction within the Risk Adjustment team, with various cross-functional teams within Blue Shield, Blue Shield IPA/MG, working directly with our vendors and supporting our Risk Adjustment IHV program. 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:

  • Make recommendations based on understanding the core principles and functionality of decision, descriptive, predictive, and prescriptive analytic methods
  • Train lower-level analysts on how to update and apply these advanced analytic techniques
  • Drive leadership, guidance, and manage all aspects of a given program, including vendor oversight, internal cross-functional partnerships, tracking performance and measuring results
  • Manage 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
  • Lead the Member Incentive Program from inception to completion
  • Work closely with corporate finance on all budget & financial reporting related including invoice, accrual and projection
  • Ability to synthesize different pieces of information, and effectively communicate that information.
  • The ability to manage projects/timelines to achieve successful outcomes.
  • Special Projects as requested.



Your Knowledge and Experience

  • Requires a bachelor?s degree
  • Requires at least 6 years of professional experience with 3 years in project management or vendor management experience
  • Excellent interpersonal, verbal and written communication and presentation skills
  • Strong interpersonal skills. Able to collaborate with other cross-functional areas to meet objectives
  • The ability to manage projects/timelines to achieve successful outcomes.
  • Independent problem solver, proactive, able to multitask. Patience for working on large scale problems
  • Proficient with MS Office (Excel, Word, PowerPoint and Visio)

Pay Range

The pay range for this role is: $ 118800.00 to $ 178200.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Salary : $118,800 - $178,200

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