Senior Manager, Risk Adjustment Vendor Management

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🔥 0 minutes ago

🥔 Idaho, Ohio, +2 more states – Remote

🥔 Idaho – Remote 🏈 Ohio – Remote 🔔 Pennsylvania – Remote 🤠 Texas – Remote

💵 $67.9k - $182.5k / year

⏰ Full Time

🟠 Senior

🛒 Procurement

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Manage risk adjustment vendors • Lead procurement processes, quality oversight, and performance reporting • Work with subject matter experts across all lines of business to establish and champion local market culture committed to revenue integrity excellence • Interact directly with internal colleagues and, as appropriate, external provider and vendor partners • Analyze member- and provider-specific intervention opportunities and effectiveness around complete and accurate diagnosis capture and reporting • Report to the Revenue Integrity Lead Director of Provider Support and Enablement

🎯 Requirements

• 7+ years of experience combining management consulting, project consulting, change management, business process consulting, project management, and/or strategic business planning • 3+ years of Risk Adjustment experience or experience working with Risk Adjustment Vendors • Demonstrated senior-level relationship management skills • Ability to quickly build and maintain credible relationships at varying organizational levels simultaneously • Experience with enterprise-wide and/or cross-functional large-scale initiatives with a high degree of complexity • Bachelor's degree or equivalent work experience • People leadership experience preferred

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being