Emergent Holdings · 2 days ago
Manager, Risk Adjustment
United States
Full-time
Remote
Senior Level
$89K/yr - $148K/yr
7+ years exp
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Responsibilities
Responsible for managing large scale, current and multi-year plan strategy development in a dynamic and evolving environment.
Manage and continuously improve end-to-end process model operations.
Oversee data driven performance management of processes, programs, vendors, staff and providers. Conduct operations in a planned, metric-driven approach.
Provide leadership, planning, project coordination and management for the development of a cost-effective department while concurrently facilitating efficient operations to meet current and future business needs within the organization.
Participate in the development of programs as a strategic partner that supports the company plan.
Participate in development of annual departmental budget, monitor budget and identify budget discrepancies. Research cause and make recommendations.
Responsibility for balancing workload to optimize the effectiveness of the department.
Implement data quality controls. Conduct reasonableness checks and validate data.
Present data to different audiences. Look at existing views of data presentation and create improved views. Seek to understand and explain data trends by doing deeper analysis.
Interpret data and write insights to explain performance and assist leaders in decision making.
Continuous improvement mindset to continuously look for more efficient ways to present information, create report deliverables, etc.
Manage activities of a department including but not limited to planning, problem solving, staff development and communication.
Execute function/area objectives that support continuous improvement.
Manage professional employees. Responsible for special projects and/or problem resolutions.
Provide effective and efficient solutions to complex business problems. Provide high level oversight and leadership.
Qualification
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Required
Bachelor's Degree in related field required.
Seven years of progressively more responsible experience in a healthcare environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities.
Three years of leadership experience in healthcare management required.
Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
Ability to work with and empower others on a collaborative basis to ensure success of unit team.
Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions and employing active listening techniques.
Ability to effectively present budgetary and/or cost information, and respond to questions as appropriate.
Ability to establish workflows, manages multiple projects, and meets necessary deadlines.
Ability to work under general direction.
Ability to work effectively in a team environment.
Good analytical, organizational, planning, verbal and written communication skills.
Strong technical business writing skills.
Act with sense of urgency.
Ability to know when to bring focus and attention to issues.
Ability to appropriately package current state analysis and present to leaders/executives.
Knowledge of impact analysis and financial risk adjustment impact analysis.
Ability to manage multiple points of integration between internal systems and vendors.
Strong Power Point and Excel skills.
Database skills, including SAS, SQL and Access are strong enough to lead a team that regularly utilizes these tools.
Extensive experience and knowledge of health insurance and risk adjustment.
Knowledge of Medicare Advantage, CMS and HHS regulations.
Preferred
Master's Degree in related field considered a plus.
Certification or progress toward certification is highly preferred and encouraged.
Experience in risk adjustment implementing new risk adjustment programs for Medicare Advantage or Medicaid products preferred.
Company
Emergent Holdings
Emergent Holdings’ elite team makes lives, companies and communities better! Emergent Holdings is driven by a singular goal — improving the health and safety of our customers and our communities.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
John S. Roberts
Executive Vice President, Emerging Markets & Chief Administrative Officer
Brittanie Benson
Human Resources Business Partner
Company data provided by crunchbase
