Risk Adjustment - Strategy Associate

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="https://s3.amazonaws.com/data.vizirecruiter.com/Images/BCBSMCareers+-+Quick+Reference+Guide.pdf" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="https://ejko.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_3/requisitions" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

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Competitive Total Compensation Package

Overview: <strong>Responsible for making recommendations on highly consequential matters, with long-term implications for the organization including setting enterprise priorities, development of strategies and assessment of strategic investments and partnerships. Consider market trends and changes, identify, prioritize and develop strategies to enable the future state of Blue Cross Blue Shield of Michigan (BCBSM), Blue Care Network and its subsidiaries.</strong>
Responsibilities: <ul> <li>Frame and drive thorough analysis to develop recommendations of strategy development opportunities.</li> <li>Support teammates in leading the business through strategy development and on to execution.</li> <li>Develop statistical and financial models in Excel and other tools to project the impact of market events, competitor actions, strategic initiatives, and new business opportunities on metrics such as membership, cost to serve, and margin; evaluating potential actions and developing recommendations.</li> <li>Create executive level presentations and correspondence to communicate recommendations to executive leadership and the Board of Directors.</li> <li>Maintain a point of view on where the health care industry is headed and provide a perspective on how BCBSM should respond in light of changing industry trends.</li> <li>Understand the economic and financial drivers of our business and ensure that the strategic perspective is articulated within business plans.</li> <li>Act as a thought partner to enterprise leadership in the development and prioritization of long-term strategies.</li> </ul>
Requirements: <strong>Qualifications</strong> <ul> <li>Bachelor&rsquo;s degree required with a major in business, public health, policy, or mathematics preferred.</li> <li>Three (3) or more years of experience in a related field required.&nbsp; Health care industry experience is strongly preferred.</li> <li>Previous experience in management consulting, investment banking, policy, or corporate strategy at a complex organization is highly desired.</li> <li>Intellectual curiosity.</li> <li>Structured and logical thinker with advanced analytical and problem-solving skills.</li> <li>Advanced written communication ability necessary to develop and frame a story line to communicate strategic ideas.</li> <li>Advanced quantitative skills and ability to interpret data from multiple sources; ability to synthesize complex data, information and reports into clear and simple ideas.</li> <li>Intermediate oral communication skills.</li> <li>Expert proficiency with Microsoft Office software (PowerPoint, Excel, and Word) is required.</li> <li>Ability to work independently within a team environment, occasionally giving direction to others within the department and cross-functionally on a project basis.</li> <li>Ability to effectively interface with employees at all levels, developing agendas and leading meetings at times.</li> <li>Comfort with large data sets, data modeling and interpretation is preferred.</li> </ul> <br /> <p><strong>The mission of the Commercial Risk Adjustment Strategy and Performance team is to:</strong></p> <ul> <li>Optimize risk scores and revenue for the enterprise associated with submission of supplemental data to the Department of Health and Human Services (HHS) EDGE server through a partnership with the Commercial Submissions team and the operational and submission vendors.</li> <li>Provide end to end oversight of the strategic direction and execution of the commercial risk adjustment program.</li> <li>Establish controls to ensure the programs supporting supplemental submissions are functioning effectively.</li> <li>Collaborate with key stakeholders to maximize the outcome of strategic initiatives and performance.</li> <li>Oversight of the HHS Risk Adjustment Data Validation (HRADV) audits.</li> </ul> <p>&nbsp;&nbsp; &nbsp;</p>