Anthem, Inc. Medicare Risk Adjuster Innovation Director Senior in New York City, New York
SHIFT: Day Job
Medicare Risk Adjuster Innovation Director Senior
Be part of an extraordinary team
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Build the possibilities. Make an extraordinary impact.
The Medicare Risk Adjuster Innovation Director Senior is Responsible for developing and overseeing an enterprise-wide Medicare reporting and analytics strategy to drive Medicare risk adjustment.
How will you make an impact:
Effectively supporting and working directly with technical teams (IT, Data Science, Claims, etc) to develop enhanced reporting and analytics, both internal and external. Oversee and develop data completeness and accuracy reporting.
Develop innovative strategies and tactics to improve the accuracy of risk scores and reduce payment error risk.
Act as subject matter expert to guide the IT and claims team.
Responsible for reporting tracks data from receipt at Anthem to submission and acceptance at CMS.
Develop automated data reports to value based provider network that enables data remediation and reconciliation.
Support financial forecasting and risk score projections for the Medicare bids.
- Requires a BA/BS degree and a minimum 10 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred skills, Capabilities and Experiences
- Thorough Medicare knowledge strongly preferred. MBA preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem 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 firstname.lastname@example.org for assistance.