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Risk Adjustment Consultant

1 month ago

Long Beach, California, United States Blue Shield of California Full time

Your Role

The Risk Adjustment Consulting team at Blue Shield of California is seeking a highly skilled and experienced professional to join our team as a Risk Adjustment Consultant. In this role, you will lead the Member Incentive Program and support the In-Home Visit program within the Risk Adjustment team.

Your Work

As a Risk Adjustment Consultant, you will be responsible for:

  • Developing and implementing advanced analytic techniques to improve member risk data and score submissions.
  • Training lower-level analysts on how to update and apply these techniques.
  • Managing all aspects of a given program, including vendor oversight, internal cross-functional partnerships, and tracking performance and measuring results.
  • Managing data analysis, documenting and verifying assumptions used in computations, and establishing revenue accruals.
  • Leading the Member Incentive Program from inception to completion.
  • Supporting the In-Home Visit program by working with the program lead to address various tasks needed.

Your Knowledge and Experience

  • Requires a bachelor's degree.
  • Master's degree preferred.
  • Requires deep knowledge of job area obtained through professional experience and advanced education.
  • Requires at least 6 years of professional experience with 3 years in project management or vendor management experience.
  • Requires excellent interpersonal, verbal and written communication and presentation skills.
  • Requires strong interpersonal skills and ability to collaborate with other cross-functional areas to meet objectives.
  • Requires the ability to manage projects/timelines to achieve successful outcomes.
  • Requires the ability to problem solve, be proactive, able to multitask and patient for working on large scale problems.
  • Requires proficiency with MS Office (Excel, Word, PowerPoint and Visio).
  • Risk Adjustment professional experience preferred.

Pay Range:

The pay range for this role is: $118,800.00 to $178,200.00 for California.

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, and current employee salaries for similar roles.