Retrospective Program Manager, Medicaid Risk Adjustment
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.
This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
We have an outstanding opportunity for an enthusiastic team player to manage Risk Adjustment National Programs for the Aetna Better Health Medicaid Plans.
Reporting to the Lead Director of Medicaid Risk Adjustment National Programs, this individual will work closely with risk adjustment programs to monitor performance, track activities and drive innovation while being committed to revenue integrity excellence.
This position will contribute to Medicaid RAF performance through the delivery of measurable and actionable solutions while working within Medicaid regulatory and state specific contractual requirements.
Required Qualifications
3+ years of project management experience.
Preferred Qualifications
- 2+ years in Medicaid or Risk Adjustment health care industry experience.
- Certified Risk Adjusted Coder (CRC) or Certified Professional Coder (CPC).
Education
Bachelor’s degree in Finance, Health Care Administration or equivalent experience
Pay Range
The typical pay range for this role is :
$54,300.00 - $139,200.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.
The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.
CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.
Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
Retrospective Program Manager, Medicaid Risk Adjustment
Reporting to the Lead Director of Medicaid Risk Adjustment National Programs, this individual will work closely with risk adjustment programs to monitor performance, track activities and drive innovation while being committed to revenue integrity excellence. We have an outstanding opportunity for an...
Occupational Health and Safety Manager (Program Manager I) - Risk Management
Develop and implement various employee safety programs such as safety recognition programs, emergency preparedness programs, or emergency evacuation procedures. Coordinates Risk Management activities with the County Risk Manager. The Safety Manager is responsible for developing, coordinating, and ov...
Prospective Programs Manager, Medicaid Risk Adjustment
Reporting to the Lead Director of Medicaid Risk Adjustment National Programs, this individual will work closely with risk adjustment programs to monitor performance, track activities and drive innovation while being committed to revenue integrity excellence. We have an outstanding opportunity for an...
Government Programs Risk Adjustment Coder
The Capital BlueCross Government Programs Risk Adjustment coding position is a unique position that combines knowledge and experience in risk adjustment coding, Medicare and Government regulations, Medicare Advantage risk adjustment model, HHS ACA risk adjustment models, and RADV and HRADV experienc...
Center for Precision Medicine for High Risk Pediatric Cancer Clinical Research Program Manager I
This program is looking for a Program Manager to assist with the coordination of various early phase clinical trials. The Center for Precision Medicine for High-Risk Pediatric Cancer is focused on developing molecularly targeted anti-cancer therapies for pediatric patients with cancer, with the goal...
Associate Director, GDS&PV Signal Detection & Risk Management Scientist
At Genmab, we’re committed to building extra[not]ordinary futures together, by developing antibody products and pioneering, knock-your-socks-off therapies that change the lives of patients and the future of cancer treatment and serious diseases. As our Associate Director, you must effectively implem...
Research Security Program Manager
The Research Security Program Manager will have overall responsibility for coordinating the expected federal research security program requirements once created. Research Security Program Manager. The Research Security Program Manager reports to the Director of Research Security and Trade Compliance...
Mortgage QC & Compliance Support Analyst
Mortgage QC & Compliance Support Analyst. Analyzes quality control and compliance review results for loans in-process and post-closing for credit, compliance, documentation deficiencies and investor stability. This position is primarily responsible for supporting Origination & Servicing QC leadershi...
Pharmacovigilance Risk Management Medical Director (PVRM)
The role supports regulatory compliance with pharmacovigilance regulations, safety signal detection/management, and contributes to the overall benefit-risk management of Exelixis products. The PVRM Medical Director is responsible for the medical review of Individual Case Safety Reports (ICSRs) for E...
Senior/Enterprise Risk Management Manager
Develop and implement risk management tools, works with departments in performing risk assessments, works with project managers and with operations management on projects and analyses of importance to the Bank. You will coordinate, oversee, and perform tasks essential to the Bank's Enterprise Risk M...