Vendor Manager, Coding

Job not on LinkedIn

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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

• Lead and oversee external coding vendor operations • Ensure contractual obligations, Service Level Agreements, quality performance, and accurate ICD-10/HCC coding deliverables are met • Lead routine operational meetings with vendor leadership • Review performance gaps, process improvements, and strategic goals • Track daily, weekly, and monthly service levels, audit tiers, and performance metrics • Align staffing models with volume projections alongside resource planning and vendor leadership • Maintain rosters of active and inactive coding contractors • Manage audit record queues for representative sampling • Manage user accounts in Workday, including adding new hires and terminating departing users • Administer roles, environment permissions, and feature access within the coding application • Issue and track activation and deactivation tickets for coding contractors • Partner with Engineering to troubleshoot and resolve technical access or permission issues • Ensure vendor adherence to contractual obligations, corporate policies, and PHI/HIPAA security standards • Monitor CVS compliance and training audit communications and follow up with vendors • Conduct targeted quality reviews of health risk evaluations for clinical accuracy and ICD-10/HCC alignment • Identify operational risks and implement governance frameworks to correct compliance or delivery gaps

🎯 Requirements

• Minimum of 5 years of hands-on ICD-10 coding experience • 5–7 years in vendor management or operational supervisory roles • Certified Professional Vendor Manager (CPVM) or Project Management Professional (PMP) certification required • Active coding credential (CPC, COC, CCS, CCS-P, or CCA) preferred • Certified Risk Coder (CRC) certification preferred • In-depth knowledge of Risk Adjustment (HCC) protocols across Medicare, Medicaid, and ACA Exchange lines of business • Experience managing user permissions in Workday and enterprise application administration platforms • 40 anticipated weekly hours

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility