Government Health Risk Adjustment Consultant
MMC

Job Info

---

Mercer's Government Human Services Consulting (GHSC) practice focuses on the unique and challenging needs of the public health care sector, providing a wide array of consulting services to local, state, and federal government agencies across the country. GHSC helps clients achieve better outcomes, develop and deploy defensible strategies, and reshape the delivery of health care. We deliver an individualized focus, powered by industry-leading experience, integrated capabilities and passionate people. GHSC has been partnering with states and other stakeholder organizations for over 35 years to face the demands and pace of change with data driven pricing, clinically-informed policy and trusted, reliable strategies to manage and deliver care.

Mercer is currently recruiting for a Government Healthcare Risk Adjustment Consultant to work in one of the following offices: Phoenix, Atlanta, Washington DC or Minneapolis.

Government Healthcare Risk Adjustment Consultant

What can you expect?

• Serve as the risk adjustment subject matter expert (SME) for large and complex projects and proposals for our California Medi-Cal client.
• Lead the accurate and timely data and financial analysis on California Medi-Cal managed health and welfare capitation projects.

What is in it for you?

• Work for a global company with excellent benefits and a dynamic culture
• Opportunity to surround yourself with other lifelong learners, while collaborating on meaningful work in a fast-paced, team environment.
• Excellent growth/advancement opportunity

We will count on you to:

• Provide detailed financial and data analyses and communicate the results for small- to large-scale projects
• Design procedures to validate operational performance and data quality metrics of financial and claims data and oversee the performance of those procedures
• Collaborate with Actuarial/Financial and Informatics team members to successfully complete all steps of California Medi-Cal health plan risk score development, including claims data intake and validation, calculation and validation of risk scores, and client and health plan reporting
• Develop and implement customized and innovative risk adjustment methodologies and models to fit the needs of the California Medi-Cal program
• Design complex analyses leveraging risk adjustment analytics to support various aspects of capitation rate development and the California Medi-Cal managed care program
• May project manage multiple tasks on different projects simultaneously to include the following: design project work flow and assign project tasks to staff; manage the quality and timeliness of project deliverables
• Draft project communications and present results and analysis to clients and key stakeholders. During presentations, answer detailed and challenging questions
• Direct the work of employees in a team and/or coach/mentor others

What you need to have:

• BA/BS degree
• Minimum two years of health data, financial, predictive, or actuarial analysis or health plan/ managed care industry experience required
• Risk adjustment analytics experience required; familiarity with common Medicaid risk adjustment model preferred
• Thorough understanding of general health care concepts, government health and welfare field preferred
• Strong critical thinking and analytical problem-solving skills; strong command of Excel
• Excellent interpersonal skills; strong oral and written communication skills

What makes you stand out:

• Experience related to the California Medi-Cal program
• Ability to prioritize and handle multiple tasks in a demanding work environment
• Ability to lead teams to deliver project objectives
• Ability to work independently and on a team

Mercer believes in building brighter futures by redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. Mercer's more than 25,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a business of Marsh & McLennan (NYSE: MMC), the world's leading professional services firm in the areas of risk, strategy and people, with 76,000 colleagues and annual revenue of $17 billion. Through its market-leading businesses including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit https://www.me.mercer.com/. Follow Mercer on Twitter @Mercer.

Marsh & McLennan Companies and its Affiliates are EOE Minority/Female/Disability/Vet/Sexual Orientation/Gender Identity employers.

The applicable base salary range for this role is $58,300 to $97,200.

The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.

This job has expired.