Health Care Manager - Enterprise Risk Adjustment - HEA000VS
DESCRIPTION/RESPONSIBILITIES:
Responsible for managing a team of Business Leads for the purpose of researching, planning, organizing, directing, implementing, and management of corporate programs and initiatives dedicated to enhancing health care value - Enterprise Risk Adjustment Program. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Specialize in research, planning, development, implementation and leadership.
Utilize data analytics and extensive business knowledge to manage the research, analysis, identification and evaluation of data from identified problems to evaluate existing and potential trends, competition, and issues. Possess and maintain in-depth knowledge of BCBSM business, products, programs (including risk adjustment, claims, reimbursement, benefits, provider and program data, networks, etc.), corporate organizational structure (including functional responsibilities), and complex research principles/methodologies. Lead and monitor multidisciplinary corporate programs/projects simultaneously by managing the establishment of analysis documentation to project plans and objectives to ensure goal attainment within defined parameters. Develop solutions to complex issues and present recommendations to senior management as well as employees at various corporate levels. Act as a Health Care Consultant by developing strategies and programs to reduce health care benefit costs and improve quality of care. Collaborate with appropriate IT and business areas to implement proposed solutions and manage programs to evaluate effectiveness and results. Ensure programs and initiatives encompass broad corporate scope and present significant variables. Anticipate, identify, and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities. Independently develop and plan, reports, papers and/or other materials. Will have direct supervisory responsibility which includes performance reviews. Other duties may be assigned.
EOE/Minority/Female/Disabled/Veteran
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, protected veteran status or status as an individual with a disability.
