Manager, Risk Adjustment

Centene Corporation; Phoenix (AZ); Remote; USD 88,000 - 158,000; Full time

Benefits offered by this job

Remote work

Flexible work schedules

401K and stock purchase plans

Tuition reimbursement

Job summary

Centene Corporation is seeking an experienced risk adjustment and quality improvement leader to oversee business processes for assigned products and plans. This remote role offers preference for in-state AZ applicants with occasional travel and the opportunity to drive performance across care programs.

The ideal candidate has strong certifications, at least 4 years in healthcare analytics or project management, and a proven track record leading a team of seven direct reports in AZ/NV.

Qualifications

• Requires bachelor’s degree or equivalent experience in a related field.
• Certification in CPC/CPC-H/CPMA or similar preferred; CRC required within first year.
• 4+ years of project management/operations/quality improvement or data analysis experience in healthcare.
• Experience in managed care or Medicare preferred.

Responsibilities

• Manage business processes related to risk adjustment and quality improvement for assigned products and plans.
• Lead a team of 7 direct reports in AZ and NV.
• Collaborate with cross-functional teams to optimize coding and RA programs.

Skills

Risk adjustment

Quality improvement

Team leadership

Healthcare analytics

Coding knowledge

Presentation

Multi-tasking

Education

Bachelor’s degree or equivalent experience

Tools

RA programming

Job description

Position Purpose

Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans.

Key Details

Remote role with preference in AZ location with occasional travel

Preferred Experience

Licenses and Certifications: One of the following certifications at the time of hire:CPC, CPC-H, CPC-P, CRC, CCS, CCS-P, RHIT, RHIA or CPMA. CRC is required within the first year of employment. CPMA is preferred on the second year of employment.Successfully be able to lead a team of 7 direct reports in AZ and NVStrong analytical skillsMulti-tasking and pivotingStrong understanding of coding, RA programmingStrong presenter with leadership and provider network

Education/Experience

Bachelor’s degree in related field or equivalent experience.

4+ years of project management, operations, quality improvement or data analysis/reporting experience in the healthcare industry.

Previous managed care or Medicare experience preferred.

Pay Range

Pay Range: $87,700.00 - $157,800.00 per year

About Centene

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day.

You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Benefits

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

EEO / Inclusion Statement

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act