Risk Adjustment Manager (Remote/Hybrid)

Centene Corporation; Pennsylvania; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules

Job summary

Centene Corporation in Pennsylvania seeks a skilled professional to manage risk adjustment and quality improvement across assigned products and plans. You will develop action plans, partner with departments, and implement workflows tailored to product requirements and local markets.

The role involves evaluating risk strategies, supporting health plan initiatives, and preparing dashboards for senior management to identify opportunities for improvement.

Qualifications

• 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.
• Clinical or Social work experience preferred.
• Previous managed care or Medicare experience preferred.
• MLTSS experience is plus.

Responsibilities

• Develop and implement action plans across departments to address issues identified by business units, with workplans, issue logs, and progress reports.
• Identify and partner with departments to implement product business requirements.
• Develop and execute operational workflows tailored to each product’s business requirements, competitive landscapes, and local market dynamics.
• Evaluate and manage the risk adjustment strategy across functional areas impacting assigned products.
• Identify and support health plan initiatives related to assigned products.
• Prepare dashboards for senior management and identify improvement opportunities.

Skills

Risk adjustment

Quality improvement

Project management

Operations

Data analysis

Healthcare exp.

Education

Bachelor’s degree

Job description

Centene Corporation in Pennsylvania seeks a skilled professional to manage risk adjustment and quality improvement across assigned products and plans. You will develop action plans, partner with departments, and implement workflows tailored to product requirements and local markets.

The role involves evaluating risk strategies, supporting health plan initiatives, and preparing dashboards for senior management to identify opportunities for improvement.