Manager, Risk Adjustment
Remote-IA, United States
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s four assigned products and plans.
- Develop and implement action plans, across all departments affecting assigned products and plans, to address issues identified by the business units, including detailed workplans, issue logs, and progress reports
- Identify and partner with various departments to implement assigned products business requirements
- Develop and execute operational workflows specific to each product business requirements, competitive landscapes, and local market dynamics
- Evaluate and manage the risk adjustment strategy across all functional areas that impact assigned products
- Identify and support health plan initiatives related to assigned products
- Prepare dashboards for senior management and identify improvement opportunities
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. Total compensation may also include additional forms of incentives.
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
Job Profile
Holidays
Benefits/Perks401(k) Competitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Flexible work schedules Health insurance Holidays Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility
Tasks- Data Analysis
- Develop
- Develop action plans
- Evaluate strategies
- Identify improvement opportunities
- Manage risk adjustment processes
- Reporting
Access Analysis Benefits Business Business Processes Dashboards Data analysis Education Flexibility Healthcare Healthcare industry Health Insurance Health Plan Insurance Managed Care Management Medicare Operations Project Management Quality improvement Reporting Reports Risk Adjustment Strategy Workflows
Experience4 years
EducationAS Bachelor's degree Business Education Equivalent Equivalent experience Healthcare Insurance Management Related Field
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9