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Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com.

As the Risk Adjustment Business Implementation Manager III, you will lead and manage the implementation of business focused projects, initiatives, and work efforts to achieve organizational Coding Quality and Risk Adjustment (RA) goals, optimize the program’s clinical benefit and financial accuracy, and ensure program compliance with governing bodies’ regulations. This role will provide leadership cross-functionally to ensure objectives of assigned work are met and that work is completed on time and in line with business expectations. You will support the Director of RA and RA Program Managers in the development, operationalization, and coordination of integrated strategies. This will include conducting quantitative and qualitative analyses of initiative impact, managing a portfolio of RA initiatives, working with numerous teams on deployment and operations of initiatives, promoting continuous quality improvement, and creating and maintaining tools and visual aids to effectively document and communicate program performance across the organization. The position requires additional focus on annual policy and procedure updates, ongoing coordination of compliance activities, budget management, and vendor contracting coordination for the RA and Coding Quality program. Join this mission driven and passionate team in our pursuit of making healthcare work better.

This position is open to either hybrid or telecommuter.

What you’ll do:

• Support the RA Program by building tools and resources to help manage RA Program priorities
• Support the Director in the development of strategies & tactics to achieve program goals
• Develop materials to showcase the strategy and tactics deployed by the RA Program
• Conduct project management of integrated strategy initiatives
• Act as liaison between RA Program & key partners outside the department
• Coordinate updates to all performance and status reporting
• Analyze risk adjustment data to identify opportunities for improvement
• Coordinate annual policy, procedure, workflow review
• Coordinate compliance audits; represent RA Program at compliance meetings
• Respond to RFPs about RA Program and BCBSA surveys
• Manage budget in coordination with RA Managers and Director
• Coordinate vendor contracting activities (including offshore approvals) in coordination with RA Managers

What you’ll bring:

• Bachelor’s degree in business or the equivalent of 4 years business experience (Required)
• 5 years of implementation management, business management or project management experience (Required)
• Strong PowerPoint and Excel skills
• Budgeting experience
• Vendor contracting and vendor management experience
• Prior Risk Adjustment experience preferred

What we offer

• Medical, vision and dental coverage
• Life and disability insurance
• Retirement programs (401K employer match and pension plan)
• Wellness incentives, onsite services, a discount program and more
• Tuition assistance for undergraduate and graduate degrees
• Generous Paid Time Off to reenergize
• Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

National Salary Range:

National Plus Salary Range:

*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.