Medicaid Risk Adjustment Market Lead

CVS Health Corporation; Indianapolis (IN); On-site; USD 54,000 - 146,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Retirement Savings

Wellness Programs

Job summary

CVS Health Corporation is seeking a Medicaid Market Manager to lead risk adjustment initiatives across markets. The role connects national strategy with market execution and requires presenting insights to senior leaders and executives.

The position focuses on performance management, data analysis, and cross-functional collaboration to drive accuracy, timeliness, and engagement in Medicaid risk programs. Strong communication and project management are essential.

Qualifications

• 5+ years of experience presenting to senior leaders and cross-functional audiences.
• 2+ years experience with health insurance regulatory and contractual requirements.
• Experience leading recurring territory meetings with health plan executives and territory presidents.
• Ability to independently research and validate information from multiple sources.
• Advanced PowerPoint skills with executive-ready decks (charts, storytelling).
• Proven track record of leading cross-functional projects end-to-end with timelines and status reporting.
• Ability to translate complex data into concise, actionable insights.

Responsibilities

• Function as a face of Revenue Integrity across market teams.
• Deliver executive level presentations highlighting performance drivers and solutions.
• Investigate operational issues and implement solutions.
• Track deliverables and identify barriers in market engagement.
• Develop educational material to support market intelligence.
• Lead territory meetings with health plan executives and presidents.
• Lead working groups with provider engagement, network, and quality partners.
• Coordinate deliverables and timelines using project management.
• Review requirements and dashboards with Informatics to enhance reports.
• Produce market-specific performance insights for governance meetings.
• Monitor risk adjustment strategy and drive market execution.
• Coordinate with local markets to ensure timely risk score performance.
• Collaborate on strategies to drive member engagement in risk programs.
• Stay informed on regulatory changes and leading practices.

Skills

Executive presentations

Regulatory requirements

Market engagement leadership

Data interpretation & storytelling

Project management

Cross-functional collaboration

Attention to detail

Prioritization & multitasking

Risk adjustment knowledge

Communication to senior leaders

Education

Bachelor's Degree

Tools

Microsoft PowerPoint

Job description

CVS Health Corporation is seeking a Medicaid Market Manager to lead risk adjustment initiatives across markets. The role connects national strategy with market execution and requires presenting insights to senior leaders and executives.

The position focuses on performance management, data analysis, and cross-functional collaboration to drive accuracy, timeliness, and engagement in Medicaid risk programs. Strong communication and project management are essential.