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Risk Adjustment Business Development Manager

Elevance Health

Location Indianapolis IN, Mason OH, Atlanta GA, Tampa FL, Grand Prairie TX, Louisville KY, St. Louis MO Hours Standard Working hours Travel/Office Requirements This role requires associates to be in-office 1-2 days per week to foster collaboration while allowing flexibility for productivity and work-life balance. Alternate locations may be considered if candidates reside within commuting distance. Candidates not within reasonable commuting distance will not be considered unless an accommodation is granted as required by law. Position Overview Responsible for leading the development of new business plans and strategies for Government Business Risk Adjustment initiatives, including Medicaid specific risk adjustment and specialty revenue assignments, Medicare Advantage [Duals] vendor interaction, risk adjustment program enhancement, and all revenue initiatives. How You Will Make an Impact Medicaid Risk methodology letters; Rate Cell Methodology letters; risk adjustment scores analysis and documentation accuracy; state specific CDPS models; creation of advanced programs to address risk score accuracy; competitor intelligence. Lead the analysis of current and projected product lines to determine optimal business strategy. Oversee research, analysis and development of recommendations on the external environment as part of strategic business plans. Analyze major competitor strategies, identify and monitor changing competition patterns, and recommend responses. Acquire and maintain data/information on market, industry, economic, consumer and competitive conditions and trends related to health insurance/managed care and related services. Consolidate data, analyses and recommendations into concise business plans. Develop and implement project plans and oversee project resources. Lead lower level staff performing related functions. Required Qualifications Requires a BA/BS degree and a minimum of 5 years of related experience; or any combination of education and experience providing an equivalent background. Preferred Qualifications Medicaid and Medicare Experience is a must have. Healthcare Risk Adjustment experience strongly preferred. Vendor Management experience preferred. Strong communication skills across various levels of the organization preferred. Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Vaccination Requirements Elevance Health requires all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Benefits We offer a range of market‑competitive total rewards that include merit increases, paid holidays, paid time off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short‑ and long‑term disability benefits, 401(k)+match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. #J-18808-Ljbffr Elevance Health

Vacancy posted 2 days ago
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