Risk Adjustment Senior Manager at Accenture

Philadelphia, Pennsylvania, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Professional Services, ConsultingIndustries

Requirements

Expertise in risk adjustment operations, including AI-driven chart reviews and advanced analytics
Strong knowledge of regulatory requirements (e.g., CMS and HHS guidelines)
Experience in product roadmap development and maintenance
Proven performance management and reporting skills
Client management experience, including serving as subject matter advisor and managing expectations
Leadership skills for building, mentoring, and directing teams
Business development capabilities, including supporting sales proposals and presentations
Willingness to travel up to 80% as needed

Responsibilities

Lead the development and continuous refinement of the firm’s risk adjustment product roadmap, leveraging cutting-edge technology like AI-driven chart reviews and advanced analytics
Establish and oversee performance management processes, ensuring operational excellence and superior client outcomes; develop and maintain reporting frameworks to monitor metrics and identify improvements
Serve as the subject matter advisor and primary point of contact for health clients on risk adjustment services; proactively identify and communicate risks, issues, and opportunities; set and manage client expectations
Monitor regulatory changes (e.g., CMS and HHS guidelines) and ensure compliance of risk adjustment services; oversee process and tool enhancements in response to regulations
Oversee performance of automated processes, including AI-based chart reviews and risk adjustment analytics; identify opportunities to improve speed, breadth, and accuracy
Support sales initiatives through proposals and presentations; leverage industry insights for growth opportunities and client base expansion
Build, mentor, and provide strategic direction to a team of junior resources; foster a culture of continuous improvement for high-quality, efficient services

Skills

Risk Adjustment

Strategy

Consulting

Data Analytics

Change Management

Cloud

Accenture

Global professional services for digital transformation

About Accenture

Accenture provides a wide range of professional services, including strategy and consulting, technology, and operations, to help organizations improve their performance. Their services assist clients in navigating digital transformation, enhancing operational efficiency, and achieving sustainable growth. Accenture's offerings include cloud migration, cybersecurity, artificial intelligence, and data analytics, which are tailored to meet the needs of various industries such as financial services, healthcare, and retail. What sets Accenture apart from its competitors is its extensive industry knowledge and ability to deliver comprehensive solutions that address both immediate challenges and long-term goals. The company's aim is to support clients in reducing their environmental impact while driving innovation and growth.

Dublin, IrelandHeadquarters

1989Year Founded

$8.5MTotal Funding

IPOCompany Stage

Consulting, Enterprise Software, CybersecurityIndustries

10,001+Employees

Risks

Rapid AI advancements may outpace Accenture's current capabilities, risking competitive disadvantages.

Integration challenges from multiple acquisitions could affect Accenture's operational efficiency.

The rise of AI-driven startups may disrupt Accenture's market share in customer service solutions.

Differentiation

Accenture's acquisitions enhance its capabilities in digital twin technology for financial services.

The company is expanding its expertise in net-zero infrastructure through strategic acquisitions.

Accenture's focus on software-defined vehicles positions it as a leader in automotive innovation.

Upsides

Accenture's investment in EMTECH supports central bank modernization amid digital currency evolution.

The acquisition of Award Solutions boosts Accenture's presence in the growing 5G and IoT markets.

Accenture's strategic acquisitions align with high-growth markets like digital twins and net-zero projects.

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