Risk Adjustment Execution and Enablement Manager, Analytics & Reporting - Hybrid

Posted Yesterday
Be an Early Applicant
2 Locations
Hybrid
102K-184K Annually
Senior level
Healthtech • Insurance
The Role
Manages analytics, reporting tools, healthcare data sets, and analyst teams supporting risk adjustment programs. Oversees medical record retrieval, high-volume healthcare data processing, reporting, and insights. Coordinates internal stakeholders and external vendors, develops analytical capabilities, evaluates new data sources and methodologies, and supports Medicare, ACA, and risk adjustment operations.
Summary Generated by Built In

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

As a member of the Risk Adjustment Execution & Enablement team, this position is responsible for managing analytical and reporting tools and healthcare data sets to produce valuable insights that improve the quality of the division's business. This role will gain a deep understanding of medical records, claims, and eligibility data in order to plan, manage, and control the activities of a team of analysts that provide reporting, insights, and analytics in support of division data needs. The position is accountable for leading large-scale medical record retrieval operations, overseeing the storage, movement, processing, and analysis of high-volume healthcare data, and coordinating efforts with internal partners and external vendors to support risk adjustment programs. This leader will develop the team's analytical capabilities, impart knowledge of analytical methods, research, and statistics used in quantitative data analysis, identify opportunities to leverage new data sets, tools, and methodologies, and work closely with customers and stakeholders to build and sustain strong relationships.

JOB REQUIREMENTS:

  • Bachelor and 3 years’ experience in presenting analytic results/insights to audiences at different levels OR 6 years analytics experience;

  • 4 years’ experience in data analysis and information reporting;

  • 1 years leadership and/or supervisory experience

  • Experience with negotiation, decision making, organizational, and analytical skills;

  • Interpersonal skills including but not limited to verbal and written communication;

  • PC experience to include Access, Excel, Word, and PowerPoint.

  • SQL, SAS and Teradata or other reporting tools / languages experience.

  • Initiative to solve complex problems; takes an outside in perspective to identify innovative solutions.

PREFERRED JOB REQUIREMENTS:

  • Bachelor degree in mathematics, actuarial science, statistics.

  • Experience working with the Medicare, Part D Prescription Drug, Medicare Advantage Programs, or ACA

  • Experience with healthcare data, including medical records, claims, eligibility data, and PHI.

  • Knowledge of ACA and/or Medicare Advantage (MA) Risk Adjustment.

  • Experience with medical record retrieval and healthcare data operations.

  • Proficiency in SQL and querying large datasets.

  • Experience with Teradata and Alteryx.

  • Experience managing vendor relationships and cross-functional initiatives.

  • Experience working with large-scale data storage, processing, and file management.

Locations: Chicago, IL or Richardson, TX

Schedule: This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Sponsorship: Sponsorship is not available

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$102,000.00 - $184,300.00

Exact compensation may vary based on skills, experience, and location.

Skills Required

  • Bachelor's degree and 3 years of experience presenting analytic results or insights to audiences at different levels, or 6 years of analytics experience
  • 4 years of experience in data analysis and information reporting
  • 1 year of leadership or supervisory experience
  • Negotiation, decision-making, organizational, and analytical skills
  • Verbal and written communication skills
  • PC experience with Access, Excel, Word, and PowerPoint
  • Experience with SQL, SAS, Teradata, or other reporting tools or languages
  • Initiative to solve complex problems and identify innovative solutions
  • Bachelor's degree in mathematics, actuarial science, or statistics
  • Experience with Medicare, Part D Prescription Drug, Medicare Advantage, or ACA programs
  • Experience with healthcare data, including medical records, claims, eligibility data, and PHI
  • Knowledge of ACA or Medicare Advantage risk adjustment
  • Experience with medical record retrieval and healthcare data operations
  • Proficiency in SQL and querying large datasets
  • Experience with Teradata and Alteryx
  • Experience managing vendor relationships and cross-functional initiatives
  • Experience with large-scale data storage, processing, and file management

Health Care Service Corporation Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Health Care Service Corporation and has not been reviewed or approved by Health Care Service Corporation.

  • Retirement Support A pension plan alongside a matching 401(k) is offered, an uncommon combination in the private sector. This combination is described as a standout element that helps retain employees.
  • Healthcare Strength Healthcare options are broad, with multiple medical, dental, and vision choices, wellness incentives, and access to resources like on-site fitness centers and an EAP. These offerings add meaningful value beyond base pay.
  • Parental & Family Support Paid parental leave (up to six weeks at full pay after one year), adoption assistance, and mothers’ rooms are available. These supports reinforce family needs alongside work commitments.

Health Care Service Corporation Insights

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The Company
HQ: Chicago, IL
13,563 Employees

What We Do

Imagine Something New, Something Different. Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families. HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development. HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC. Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization. Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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