Risk Adjustment Manager

Job not on LinkedIn

🔥 4 hours ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Manage business processes related to risk adjustment and quality improvement across assigned products and plans • Develop and implement action plans across departments affecting assigned products and plans • Create detailed workplans, issue logs, and progress reports • Identify and partner with departments to implement assigned product business requirements • Develop and execute operational workflows specific to product business requirements, competitive landscapes, and local market dynamics • Evaluate and manage 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

🎯 Requirements

• 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 a plus • Ideal candidate to live in the state of PA

🏖️ Benefits

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Benefits may be subject to program eligibility