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Medicare Risk Adjustment Manager

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Category:
IT - Administration

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Contract Type:
Employment contract

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Salary:

54300.00 - 119340.00 USD / Year
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Job Description:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Responsibility:

  • Leading Risk Adjustment for the Southeast Region, specifically in GA/Gulf States
  • Maintaining and improving risk adjustment accuracy by partnering closely with leadership from key value-based providers
  • Driving, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical record collection, provider collaboration and data sharing, general coding education and related activities

Requirements:

  • 5+ years of experience with one or more of the following methodologies: risk adjustment, clinical quality, or healthcare quality improvement
  • Certification in coding (CPC, CRC, RHIA, etc. through AAPC or AHIMA)
  • Experience working in provider offices, accountable care organizations and / or value-based provider relations
  • Strong time management, project management, change management, organizational, research, analytical, negotiation, communication, and interpersonal skills
  • Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web-based meetings
  • Must be able to manage ambiguity and work in fast paced environment
  • Excellent stakeholder relationship management skills

Nice to have:

  • 7+ years of experience in risk adjustment, clinical quality, or healthcare quality improvement required
  • experience supporting provider‑based or value‑based initiatives preferred
  • Candidates residing in Georgia or the Southeastern United States are preferred
  • Bachelor’s degree preferred, or a combination of relevant professional experience and education
What we offer:
  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Bonus, commission or short-term incentive program

Additional Information:

Job Posted:
May 15, 2026

Expiration:
July 08, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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