Manager, Actuary

Blue Shield of California • Oakland, CA

1d

About The Position

Your Role The Risk Adjustment team is hiring a Manager of Risk Adjustment Provider Analytics. The Manager, Actuary will report to the Director of Risk Adjustment Analytics. In this role you will manage a team whose primary responsibility is performing risk adjustment analytics to support provider engagement, which includes developing and maintaining provider dashboards, provider-specific deep dive analyses, and reporting of key metrics for all risk adjustable lines of business. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Responsibilities Your Work In this role, you will: Have overall responsibility and accountability for reviewing staff work product related to CMS/ACA related risk adjustment processes, forecasting, trend setting, and/or network development and alternative provider payment models Be responsible for developing and managing experience tracking reports, comparisons to plan, tracking and quantifying variances, and sharing insights with the business unit and management Ensure team follows existing work flow procedures or policies and/or validates or develops new procedures and policies Be responsible for understanding current and emerging regulatory and competitive developments, facilitating communication of these developments, and ensuring processes and procedures are consistent with changing regulations Lead special projects/committees/task forces Lead a team of 3-5 analysts to ensure that the Risk Adjustment Provider Partnerships team receives adequate analytical support for provider engagement Support for provider engagement includes: maintenance, development, and enhancement of provider-level reporting, creation of new reporting tools and dashboards to improve accessibility to key performance metrics, and deep dive analyses to understand risk score variances Qualifications Your Knowledge and Experience Requires a bachelor’s degree in actuarial science, mathematics, statistics, computer science or equivalent experience Requires at least 7 years prior relevant job including 3 years of experience of operating in a team leader role Requires 2 years of prior experience working primarily with Risk Adjustment, or significant evidence of major prior financial or analytical experience and significant evidence of major project management skills. Requires strong ability to communicate complex technical subjects to non-technical audiences. Requires strong project and team management skills. Requires problem-solving skills, self-motivation, detail orientation and critical thinking skills.

Requirements

• Requires a bachelor’s degree in actuarial science, mathematics, statistics, computer science or equivalent experience
• Requires at least 7 years prior relevant job including 3 years of experience of operating in a team leader role
• Requires 2 years of prior experience working primarily with Risk Adjustment, or significant evidence of major prior financial or analytical experience and significant evidence of major project management skills.
• Requires strong ability to communicate complex technical subjects to non-technical audiences.
• Requires strong project and team management skills.
• Requires problem-solving skills, self-motivation, detail orientation and critical thinking skills.

Responsibilities

• Have overall responsibility and accountability for reviewing staff work product related to CMS/ACA related risk adjustment processes, forecasting, trend setting, and/or network development and alternative provider payment models
• Be responsible for developing and managing experience tracking reports, comparisons to plan, tracking and quantifying variances, and sharing insights with the business unit and management
• Ensure team follows existing work flow procedures or policies and/or validates or develops new procedures and policies
• Be responsible for understanding current and emerging regulatory and competitive developments, facilitating communication of these developments, and ensuring processes and procedures are consistent with changing regulations
• Lead special projects/committees/task forces
• Lead a team of 3-5 analysts to ensure that the Risk Adjustment Provider Partnerships team receives adequate analytical support for provider engagement
• Support for provider engagement includes: maintenance, development, and enhancement of provider-level reporting, creation of new reporting tools and dashboards to improve accessibility to key performance metrics, and deep dive analyses to understand risk score variances

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees