National Guard Employment Network

Acts as a risk adjustment subject matter expert and resource. Principles and practices of risk adjustment program management. Act as a subject matter expert and provide guidance regarding the most complex risk adjustment activities to all levels of staff across the organization. A minimum of eight years of progressively responsible experience in healthcare finance or analytics, which included a minimum of three years of experience managing or supporting risk adjustment programs (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.

risk adjustment

Job Description We have an opportunity to join the Alliance as a Risk Adjustment Program Manager in the Risk Adjustment Department. This is a remote position within California.
WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Risk Adjustment Director, this position:
Develops, manages, implements, and supports Risk Adjustment programs and manages Risk Adjustment Department activities
Manages small- to large-scale projects that advance business outcomes to achieve strategic objectives
Acts as a risk adjustment subject matter expert and resource WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here.
Knowledge of: Research, analysis, and reporting methods
Windows based PC systems and Microsoft Word, Excel, Outlook, and PowerPoint
Principles and practices of risk adjustment program management
Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types
Application and utilization of data and analytics to drive critical financial decisions
Principles and practices of project management
Principles and practices of customer service Ability to: Provide leadership and facilitate meetings
Lead strategic planning activities
Understand metrics and create metric dashboards
Prepare narrative and statistical written reports, oral reports, correspondence, and other program documents
Analyze and evaluate data and trends and apply the results to the development of risk adjustment strategies and tactics
Act as a subject matter expert and provide guidance regarding the most complex risk adjustment activities to all levels of staff across the organization
Manage the development and implementation of projects, systems, programs, policies, procedures, and workflows
Manage multiple projects simultaneously, organize work, and achieve goals and timelines Education and Experience: Bachelor's Degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a related field
A minimum of eight years of progressively responsible experience in healthcare finance or analytics, which included a minimum of three years of experience managing or supporting risk adjustment programs (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying OTHER INFORMATION
We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Compensation Range
$107,474-$156,499 USD OUR BENEFITS Medical, Dental and Vision Plans
Ample Paid Time Off
12 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet . The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship. Additional Qualifications/Responsibilities To apply for this position, please click here. Please list VetJobs.org as your reference.
We look forward to meeting you!
#J-18808-Ljbffr

START NEW SEARCH