Location: Swampscott, MA
Consulting jobs refer to positions where individuals or teams provide expert advice to organizations on various areas such as management, technology, finance, human resources, or any sector needing specialized knowledge. Consultants analyze company issues, develop solutions, and help implement changes. These roles often feature problem-solving, critical thinking, and strong communication skills. They typically involve working with multiple clients, which brings variety and the need for adaptability. Consultants usually possess advanced education or significant experience in their field, and the work often includes travel and flexible hours to meet client needs.
Consulting jobs refer to positions where individuals, known as consultants, provide expert advice and strategic solutions to organizations across various industries. Typically, these roles are characterized by project-based work, analytical problem-solving, and collaboration with client teams. Consultants often specialize in areas such as management, technology, finance, or human resources, aiming to enhance a company's performance, efficiency, and profitability. Distinctive features of consulting jobs include frequent travel, high-paced environments, and the potential for rapid career advancement for high-performers.
Consulting jobs refer to positions where individuals provide expert advice to organizations or individuals in a specific field. These roles are characterized by problem-solving, strategic thinking, and a focus on optimizing business processes or improving organizational performance. Consultants often work for consulting firms or as independent contractors and engage in project-based work, which may involve travel and working with diverse clients. The nature of consulting provides exposure to varied industries and requires strong analytical and interpersonal skills.
and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier. We enjoy the important work we do every day in service to our members, partners, colleagues and communities.
To learn more about who we are at Point32Health, click here. Job Summary Under the supervision of the Senior Manager of Risk Adjustment Strategy & Operations, this individual will support the operations and analysis of all risk adjustment programs and serve as the primary point of contact to a select portion of our provider network. This includes strategically important business partners, such as integrated delivery
networks, large facilities and/or physician organizations. This individual will also work closely with internal departments and external vendors to ensure that risk adjustment programs are implemented and operated at the highest levels of performance.
The Risk Adjustment Consultant will also work closely with our Network Contracting, Clinical and Care Management departments to deliver timely reporting and performance management advisory services to our provider network. This individual regularly demonstrates self-direction and motivation toward completion of on-going department initiatives. Key Responsibilities/Duties - what you will be doing Provider Engagement, Data Analysis, Risk Score
Reporting: Develop and maintain strong and effective working relationships with key business and medical leaders at provider organizations within our network Manage provider outreach and ongoing communications/reporting for all risk adjustment programs and initiatives.
Serve as the risk adjustment subject matter expert to address provider concerns and assist them in understanding the complexities of risk adjustment programs and the resulting data Coordinate and facilitate regularly scheduled and ad hoc provider meetings to provide operational updates, discuss strategic initiatives and improvement opportunities Build and refine medical group specific profiles including but not limited to governance, financials, risk scores, resources, and technology Support the evaluation of medical group opportunities and challenges specific to risk adjustment performance, identify and/or modify training needs and/or programmatic interventions to improve performance and refine the engagement plans Analyze, interpret and synthesize medical group specific results and risk score trend information; deliver the results of standard and ad hoc analyses to improve awareness and understanding of risk scores and the quality, accuracy and identification of member health conditions Work collaboratively with risk adjustment provider educators and the quality assurance team to focus the provider training and education specifically related to coding accuracy and documentation to high impact providers Perform high level financial analysis on risk adjustment programs to evaluate and report financial impact to provider organizations Collaboration with Internal Stakeholders and External Vendors Develop effective and positive working relationships with internal partners (Network Contracting, Clinical Services, Provider Performance Management, Actuarial, etc.
) to collaborate on provider engagement and performance improvement initiatives Collaborate and coordinate with internal partners to conduct comprehensive analysis and deliver professional presentations to our provider network at shared meetings Manage multi-faceted vendor initiatives to ensure smooth implementation and operations Support the Risk Adjustment department in efforts to backss additional diagnosis coding opportunities that can be procured or potentially developed internally Administration Attend provider engagement meetings, document provider concerns and key decisions, and manage follow up actions as necessary Stay informed about CMS and industry trends and best practices; utilize this knowledge to recommend modifications to Point32Health's risk adjustment programs and provider engagement practices Support the development and refinement of key deliverables to our provider community, including presentations, reference material and communications Qualifications - what you need to perform the job EDUCATION, CERTIFICATION AND LICENSURE: Bachelor's degree required, preferably in related field.
Graduate degree preferred. EXPERIENCE (minimum years required) : Three to five years of experience in a progressively responsible role with stakeholder management experience in a complex operational setting or consulting role.
Previous experience working in strategy implementation, analytical and process improvement in the health care / health insurance sector either for a health plan, provider group or management consultancy is a plus. Understanding of US Health Policy and experience working with CMS, health insurers and medical providers highly desired. SKILL REQUIREMENTS: Highly energetic, organized, detail-oriented, resourceful and self-motivated Highly proficient in Microsoft Excel, Power Point and Word; additional database systems a plus Excellent interpersonal and communication skills Ability to work collaboratively with both internal and external resources Ability to develop professional and effective relationships as a strategic advisor to our provider network Ability to take responsibility, prioritize tasks and follow through to completion Ability to organize, manage, and analyze large sets of data WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.
g. lifting, travel) : Must be able to work under normal office conditions and work from home as required.
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. May be required to work additional hours beyond standard work schedule. Salary Range 99,002-128,120 Compensation & Total Rewards Overview The annual base salary range provided for this position represents a broad range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; equity with internal colleagues; and other conditions of employment.
As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law. Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes: Medical, dental and vision coverage Retirement plans Paid time off Employer-paid life and disability insurance with additional buy-up coverage options Tuition program Well-being benefits Full suite of benefits to support career development, individual & family health, and financial health For more details on our total rewards programs, visit www.
point32health. org/careers/benefits/ Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do-from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts.
Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, interactionual orientation, national origin, genetics, disability, age, or veteran status.
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demonstrating we CARE through our values, ESG initiatives and IDE journey. Our Risk Solutions/Loss Control group is looking for a Senior Risk Solutions Consultant to join our growing team in Massachusetts. This is a full-time, exempt role. This position is eligible for a fully remote work arrangement.
POSITION OVERVIEW: A Senior Risk Solutions Consultant conducts high level technical evaluations and loss analysis of more complex prospective or existing policyholders in a consultative manner. Identifies and analyzes exposures and controls. Delivers consultative and technical services to policyholders. Develops and delivers service strategies in collaboration with underwriting and agency
partners to insureds. IN THIS ROLE, YOU WILL: Conduct field surveys on prospect and existing policyholders and writes reports for underwriting. Create and deliver loss analysis.
Develop and deliver meaningful service solutions. Create and follow up on essential recommendations. Develop effective relationships with underwriting and agency partners that drives continual collaboration. Participate in underwriting pipeline, new business, and renewal meetings to provide RS perspective regarding exposure and controls. Take initiative to enhance risk solutions / industry knowledge through participation in educational programs and training sessions. Communicate ideas or positions in a persuasive
manner that build support, agreement, and commitment. Coach / mentor newer in career staff as appropriate.
WHAT YOU NEED TO APPLY: At least 5 years Risk Solutions/Loss Control field experience with a commercial lines national/regional insurance carrier. B. S. degree preferred in a related field to include health and safety, science, engineering or equivalent. Motivated self-starter with demonstrated initiative; ability to work independently with minimal direction. Strong to exceptional communication skills, both verbal & written Professional loss control certification preferred to include CSP, CFPS, CIH, PE, CPCU, ARM. Demonstrated project management skills.
Ability to work in a dynamic environment on multiple projects, tasks or assignments. This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform. CAREER DEVELOPMENT: It's not just a job, it's a career, and we are here to support you every step of the way. We want you to be successful and fulfilled. Through on-the-job experiences, personalized coaching and our robust learning and development programs, we encourage you - at every level - to grow and develop.
BENEFITS: We offer comprehensive benefits to help you be healthy, build financial security, and balance work and home life. At The Hanover, you'll enjoy what you do and have the support you need to succeed. Benefits include: Medical, dental, vision, life, and disability insurance 401K with a company match Tuition reimbursement PTO Company paid holidays Flexible work arrangements Cultural Awareness Day in support of IDE On-site medical/wellness center (Worcester only) Click here for the full list of Benefits EEO statement: The Hanover values diversity in the workplace and among our customers.
The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, interaction/gender, interactionual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information, ancestry or any other status protected by law. Furthermore, The Hanover Insurance Group is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, interactionual orientation, gender identity, disability, marital status, veteran status, genetic information or any other status protected by law.
" As an equal opportunity employer, Hanover does not discriminate against qualified individuals with disabilities. Individuals with disabilities who wish to request a reasonable accommodation to participate in the job application or interview process, or to perform essential job functions, should contact us at: xyz X@ and include the link of the job posting in which you are interested.
Privacy Policy: To view our privacy policy and online privacy statement, click here. Applicants who are California residents: To see the types of information we may collect from applicants and employees and how we use it, please click here. Requisition #: 249926ahf9io63
