Manager, Risk Adjustment Analytics & Encounters

Manager Position

The Manager is responsible for providing leadership for the team involved in analytics, evaluation, modeling, and performance in support of customers to meet the growth, retention, membership, pricing, and service goals for all group and individual product lines of BCBSM and BCN Senior Health Services for key accounts, auto / national, Trust funds, and mid-small groups, individuals, consultants, providers, vendors, and managing / general agencies / agents. Monitor / mentor multiple projects simultaneously ensuring appropriate model designs and statistic methods are adopted. Drive the continuous method improvement in department analytic work. Assist in the planning and implementation of programs to improve revenue, control cost, improve quality and efficiency of services delivered to BCBSM and BCN Senior Health Services populations. Prepare presentations and technical reports in a clear and concise manner to communicate findings from analytics, modeling to leadership and other interested parties and groups. Other duties may be assigned.

Responsibilities / Tasks :

• Plans, organizes, and directs activities of an assigned business area.
• Manages staff that is responsible for delivering exemplary customer service or effective / efficient support.
• Maintains and promotes quality relationships with internal and external customers.
• Compiles and analyzes statistics and prepares activity related reports.
• Leads and participates in workgroups and task forces.
• Coordinates and sets priorities that maintain continuity in accomplishing the sales and membership growth goals set for the department.
• Recommends processes to control supply expenditures and promotes efficient use of resources.
• Participates in development of annual departmental budget, monitors budget, and identifies budget discrepancies.
• Responsible for balancing workload to optimize the effectiveness of the department.

Direction Exercised : Directly supervises exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

Employment Qualifications :

Skills / Knowledge / Abilities (SKA) Required :

Working Conditions : Work is performed in an office setting with no unusual hazards. Occasional travel is required.

Pay Range : Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $92,200 and $154,500. EEO Statement : All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status.