Take lead on data science projects to design and implement models and experiments from end to end, including data ingestion and preparation, feature engineering, analysis and modeling, model deployment, performance tracking and documentation. Work with business partners to convert ambiguous business problems in clear data science/ML specifications. Use contextual business

Develops financial models for M&A / venture investment opportunities and strategic initiatives Conducts industry, market, and company research Performs acquisition target identification and private / public screening analyses Prepares descriptive business profiles, including profiles on potential acquisition targets Supports team members in the creation of presentation ma

Lead the strategy execution for supplemental benefits on Medicare products. Develops the strategies, plans, and tactics in partnership with product managers and owners to drive profitable customer acquisition and retention which align with overall goals to achieve enrollment, revenue and profit performance and business goals. Analyzes data, develop KPIs and provides insig

Advise human resources and the organization on a broad array of employment law matters including performance management, nondiscrimination/harassment/ retaliation, employment policies, wage and hour laws, disability leave and accommodations, internal investigations, reorganizations, and immigration. Prepare and review employment related contracts and agreements. Issue spo

Build and maintain strong relationships with associates, supervisors, and managers. Participate in developing HR objectives and systems, including metrics and reports. Assist associates and managers with total rewards inquiries as a first escalation point after AskHR. Provide advice and guidance on performance management, talent management, succession planning, compensati

Uses databases for analysis and dissemination of information. Performs complex analysis of data. Researches, analyzes data, applies statistical methods when appropriate, and provides interpretation of outcomes. Identifies issues to be researched, determining affected areas, estimating the impact and contributing to the resolution. Implements improvements to process, analy

Serves as the "voice of the product" and therefore is the liaison between the business and the Scrum Teams; translating features into user stories within a teams backlog and managing, ranking and prioritizing this backlog so that it is reflective of stakeholder requirements and priorities. Final signoff and acceptance responsibility for user stories/features and backlog i

Receives referral and/or reaches out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. Conducts comprehensive clinical assessments; gathers, analyzes, synthesizes and prioritizes member needs and opportunities. Collaborates and communicates with member, family, or designated representative on a plan of care that

Responsible for developing and implementing risk adjustment strategies to facilitate accurate and complete coding, reporting, and regulatory compliance with CMS, HHS, and state guidelines. Leads efforts to ensure data integrity, accuracy, completeness and adherence to leading practices in risk adjustment coding. Identifies external partner opportunities, supports contract

Directs the implementation of the service operational strategies to provide superior, cost effective service delivery. Participates in the development and directs the implementation and monitoring of performance metrics to ensure that performance guarantees, corporate measures and regulatory requirements are met. Directs the allocation of resources to ensure appropriate s

Support the execution of the First tier (FDR) entities/Subcontractor determination process for the Medicare and Medicaid lines of business. Assist in conducting reviews for pre delegation, attestations, and abridged compliance assessments of FDR/Subcontractors. Act as a compliance resource by updating metrics for monitoring dashboards, policies and procedures, tracking do

Receives referral and/or reaches out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. Conducts comprehensive clinical assessments; gathers, analyzes, synthesizes and prioritizes member needs and opportunities. Collaborates and communicates with member, family, or designated representative on a plan of care that

About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding togethe

Applies clinical experience, health plan benefit structure and claims payment knowledge to pre service and retrospective reviews by gathering relevant and comprehensive clinical data through multiple sources. Leverages clinical knowledge, business rules, regulatory guidelines and policies and procedures to determine clinical appropriateness. Completes review of both medic

Partner closely with the Medicare team to establish and implement the Medicare Advantage Network Strategy. Acting as a representative for Provider Relations with Medicare leadership and as a representative for Medicare within Provider Relations will be the core accountability for this role. Oversees the success of value based care program strategy for Medicare business. A