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 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 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 NV Strong analytical skills Multi-tasking and pivoting Strong understanding of coding, RA programming Strong 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: $87,700.00 - $157,800.00 per year 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. 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. 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 Thanks for your interest in Centene and its subsidiary companies. We’re so glad that you’ve decided to fill out an application and take the next step to find your purpose. Also, we’re here to help support you on your candidate journey. Should you need an accommodation, please email [email protected]. Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.

Manager, Risk Adjustment.

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