Overview The Risk Adjustment Retrospective Analytics team focuses on delivering complete and accurate analytics for chart review targeting, financial impact calculations, and data submission. The Actuarial Analyst, Consultant, will report to the Manager of Risk Adjustment Retrospective Analytics. In this role you will develop and refine chart targeting lists, quantify the financial impact of the Retrospective program, and support complete and accurate data submission for both Medicare Advantage and ACA Chart Review Programs. Responsibilities Develop and refine chart targeting lists. Quantify the financial impact of the Retrospective program. Support complete and accurate data submission for both Medicare Advantage and ACA Chart Review Programs. Report to the Manager of Risk Adjustment Retrospective Analytics. Qualifications Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience. Requires at least 6 years of professional actuarial experience. Requires proficiency with MS Office, including Excel, Word, PowerPoint. Requires ability to create and validate new and existing data analytic processes, in context of broader enterprise objectives. Program management skills, along with related ability to rapidly diagnose to root-cause of analytic problems preferred. Requires finance experience, including revenue and expense accounting, healthcare enrollment and claims processing experience, and healthcare experience. Experience with HHS-Developed Risk Adjustment Model Algorithm for the commercial market preferred. Requires excellent written and spoken communication skills of technical material to executive leadership. Preferred: An ASA designation and completion of 1 to 2 courses toward FSA designation. #J-18808-Ljbffr Blue Shield of CA
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