Risk Adjustment Consulting, Associate

Your Role

The Risk Adjustment Consulting, Associate will report to the Medi-Cal Encounter Submissions Manager. In this role you will provide essential support to all functions within the team including: (1) Encounter data submissions for all lines of businesses in accordance with regulatory requirements and contracts provisions. (2) Provide business logic and verify system processes are in line with the given business rules. (3) Support various projects to completion ensuring timely and accurate implementation. (4) Optimize existing processes to support department priorities.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires excellent interpersonal, verbal, and written communication and presentation skills - especially presentations of complex, technical information to non-technical audiences and from non-technical information to technical information
• Required experience with SQL / SAS / Tableau and other data/analytic tools
• Desired experience in healthcare management and state and federal regulatory data standards and requirements
• Desired experience with data reconciliation, control reports and EDI transactions specifically 837P, 837I, 837D, 277CA, and 999

Pay Range:

The pay range for this role is: $ 32.08 to $ 44.90 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.