Blue Cross Blue Shield Of Massachusetts
Healthcare
AssociateDirector,RiskAdjustmentDataandAnalytics
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“Associate Director, Risk Adjustment Data and Analytics at Blue Cross Blue Shield Of Massachusetts. Skills: Risk Adjustment, Data Analytics, Medicare, Leadership. Lead Risk Adjustment Performance and Strategic Analytics Team. Lead Risk Adjustment Data and Analytics Team”
What You'll Achieve.
Improve risk adjustment; Increase efficiency; Increase productivity; Improve plan performance
Industry & Context.
Problem resolution; Analysis
What They're Looking For.
Must Have
7 years of Medicare risk adjustment experience, Minimum 5 years of progressive leadership experience, Bachelor's degree, SAS/SQL experience required
Nice to Have
Master's degree preferred, Project Management and IT experience a plus
What You'll Do.
Lead Risk Adjustment Performance and Strategic Analytics Team
Lead Risk Adjustment Data and Analytics Team
Coordinate risk adjustment analytics
Investigate risk adjustment trends
Suggest business improvements
Represent Risk Adjustment Team on workgroups
Ensure business deliverables are met
Provide risk adjustment data
Facilitate resolution of urgent issues
Drive innovation and improvements
Improve risk adjustment performance
Increase productivity
Oversee assessment of reporting requests
Compile routine reports
Distribute routine reports
Compile ad hoc reports
Distribute ad hoc reports
Coach analytic team members
Mentor analytic team members
Develop analytic team members
Oversee submission of Encounter Data
Resolve Encounter Data errors
Represent Risk Adjustment Team interests
Influence cross-functional workgroups
Negotiate cross-functional workgroups
How You'll Work.
Team & Collaboration
Internal workgroups; Cross-functional workgroups; Government Programs leaders; Internal business leaders; Actuarial; Provider Contracting; External vendors; IT; Corporate partners
Communication Scope
Presentation skills; Facilitation skills
Process & Methodology
Project management
Full Job Description
## **Ready to help us transform healthcare? Bring your true colors to blue. ** **The Role** **Director of Risk Adjustment Data and Analytics** Under the direction of the Senior Directory of Medicare Risk Adjustment and Analytics, the Director of Risk Adjustment Data and Analytics is responsible for developing and executing the analytic plan for the Medicare and Merged Market segments. The Director of Risk Adjustment Data and Analytics will oversee the reporting, analytics and management of risk adjustment, internally and externally. The role is responsible for the strategy, execution and performance of Medicare risk adjustment reporting and analytics, infrastructure and systems to meet business objectives, partnership with Actuarial and Provider Contracting, management of external vendors, and compliance with CMS regulations. This leader is responsible for analysis, projections, and assessment of risk adjustment performance. **RESPONSIBILITIES:** * Responsible for direct leadership of the Risk Adjustment Performance and Strategic Analytics Team and the Risk Adjustment Data and Analytics Team * Design and develop metrics, reports, and dashboards to drive key strategic and tactical decisions, ensuring alignment of resources as needed, and balance workloads * Coordinate risk adjustment analytics throughout the broader organization * Investigate risk adjustment trends across all areas including enrollment, providers and claims to suggest business improvements and efficiencies * Represent the Risk Adjustment Team on internal workgroups and committees focused on reporting, analytics, and operations * Ensure business deliverables are being met and risk adjustment data is provided to Government Programs leaders and internal business leaders to inform strategic initiatives * Act as the primary contact for facilitating resolution (via analysis and reporting) on urgent issues and/or issues escalated by risk adjustment leaders. * Drive innovation and improvements through deep d
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