Anticipated End Date:2026-06-26
Position Title:Risk Adjustment Business Development Manager
Job Description:Location: Indianapolis IN, Mason OH, Atlanta GA, Tampa FL, Grand Prairie TX, Louisville KY, St. Louis MO
Hours: Standard Working hours
Travel: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Position Overview: Responsible for leading the development of new business plans/strategies for Government Business Risk Adjustment initiatives. Responsibilities will include Medicaid specific risk adjustment and specialty revenue assignments; Medicare Advantage [Duals] vendor interaction; risk adjustment program enhancement; and all Revenue initiatives.
How You Will Make an Impact:- Responsibilities include but are not limited to: Medicaid Risk methodology letters; Rate Cell Methodology letters; Risk adjustment scores analysis and scores documentation accuracy; state specific CDPS models; creation of advanced programs to address risk score accuracy; competitor intelligence.
- Leads the analysis of current and projected product lines to determine optimal business strategy
- Oversees research, analysis and the development of recommendations on the external environment as part of the development of strategic business plans
- Analyzes major competitor strategies. Identifies and monitors changing patterns of competition and recommends response
- Acquires and maintains data/information on market, industry, economic, consumer and competitive conditions and trends pertaining to health insurance/managed care and related services
- Consolidates data, analyses and recommendations into concise business plans
- Develops and implements project plans and oversees project resources
- Leads the activities of lower level staff performing related functions
Required Qualifications: - Requires a BA/BS degree and a minimum of 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications: - Medicaid and Medicare Experience is a must have
- Healthcare Risk Adjustment experience strongly preferred
- Vendor Management experience preferred
- Strong communication skills with various levels of organization preferred
Job Level:Non-Management Exempt
Workshift:1st Shift (United States of America)
Job Family:BUS > Business Dev/Growth
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
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