Medicare Risk Adjustment Educator, Senior Manager (Georgia)

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.

As the Senior Manager, Risk Adjustment (Medicare) will be responsible for leading Risk Adjustment for the Georgia & the Gulf States Medicare Market.

This role will have specific responsibility for Georgia in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key provider partners.

The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical record collection, provider collaboration and data sharing, general coding education and related activities, as well as other activities as assigned.

This position requires someone who can think strategically and act independently when working with providers. This position reports to the Lead Director of Risk Adjustment for the Georgia & the Gulf States Medicare Market (GA, LA, MS, AL, AR).

Required Qualifications :

Certification in coding (CPC, CRC, RHIA, etc. through AAPC or AHIMA)

5+ years of experience with one or more of the following methodologies : risk adjustment, clinical quality, or healthcare quality improvement

Experience working in provider offices, accountable care organizations and / or value-based provider relations

Strong time management, project management, change management, organizational, research, analytical, negotiation, communication, and interpersonal skills

Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web based meetings.

Must be able to manage ambiguity and work in fast paced environment

Excellent stakeholder relationship management skills

Preferred Qualifications :

7+ years of risk adjustment, clinical quality, or healthcare quality improvement experience

Pay Range

The typical pay range for this role is :

$75,400.00 - $162,700.00

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.

This position also includes an award target in the company’s equity award program.

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.