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Blue Shield of California · 23 hours ago

Manager, Actuary

California, United States

Full-time

Hybrid

Senior Level

7+ years exp

Blue Shield of California is a nonprofit organization focused on transforming healthcare to be more affordable and effective. They are seeking a Manager of Risk Adjustment Provider Analytics to oversee a team responsible for risk adjustment analytics, provider engagement, and the development of reporting tools and dashboards.

Financial ServicesHealth InsuranceNon Profit

H1B Sponsor Likely

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

Qualification

Risk AdjustmentProject ManagementTeam LeadershipActuarial ScienceData AnalysisDetail OrientationCommunication SkillsProblem-SolvingCritical Thinking

Required

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

Company

Blue Shield of California

Glassdoor3.8

Blue Shield of California is a health insurance service provider.

Founded in 1939

San Francisco, California, USA

5001-10000 employees

https://www.blueshieldca.com

H1B Sponsorship

Blue Shield of California has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (1)

2022 (41)

2021 (20)

2020 (31)