Unclassified - Oakland, CA
posted 5 months ago
In this role, you will be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute. This involves creating value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy. You will also create value for the Network team by organizing and focusing the various requests from the General Managers and Pricing Team into a prioritized, workable list. The position requires strong influencing skills across multiple functions within Blue Shield, with a drive towards consensus and an ability to handle shifting priorities and ambiguity with agility. You will lead, coordinate, and/or develop strategic, market, and competitive analysis. Additionally, you will conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms, and evaluate actuarial risk-related analysis. You will also coordinate, prepare, perform, and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of pricing, trending, reserving, provider reimbursement, and/or risk assessment strategies.