Manager, Risk Adjustment MLTC-MAP
$87.7k - $157.8kCentene Corporation
Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans.
Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J -1, OPT, or CPT.
Experience working in managed care, Medicaid, Medicare, Marketplace, or long-term care environments preferred. New York MLTC experience strongly preferred.
- Develop and implement action plans, across all departments affecting assigned products and plans, to address issues identified by the business units, including detailed workplans, issue logs, and progress reports
- Identify and partner with various departments to implement assigned products business requirements
- Develop and execute operational workflows specific to each product business requirements, competitive landscapes, and local market dynamics
- Evaluate and manage the risk adjustment strategy across all functional areas that impact assigned products
- Identify and support health plan initiatives related to assigned products
- Prepare dashboards for senior management and identify improvement opportunities
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$87.7k - $157.8k
...Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. Key Details... ...or long-term care environments preferred. New York MLTC experience strongly preferred. Develop and...SuggestedFull timePart timeH1bWork at officeLocal areaRemote workFlexible hours$96.13k - $140.19k
...Hi, we're Oscar. We're hiring a Manager, Risk Adjustment, Provider Partnerships to join our Strategic Planning team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar...SuggestedFull timeContract workRemote workWork from homeHome office$83.99k - $119.97k
...company that continues to commit to putting our employees first. Job Description: OVERVIEW OF POSITION: The Program Manager, Risk Adjustment & Stars, serves as the connective link between Alpine's technical teams (coding, data, analytics, IT) and its operational...SuggestedFull timeRemote workHome office$136k - $170k
...passionate about creating transformative change in healthcare. What we're looking for: The open manager role is on a team that directly influences internal risk adjustment coding operations and produces client-facing analytics. Our focus is on our retrospective risk...SuggestedWork experience placementSeasonal workWork at officeRemote workFlexible hours$165.95k - $248.93k
...Job Description Summary The Director, Risk Adjustment Product & Technology will lead the product roadmap, and technology capabilities... ...combine expertise in risk adjustment, healthcare product management, clinical technology, data, workflow design, and value-based...SuggestedFull time$100k - $231.54k
...Insights) to lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions. This role... ...oversee analytics delivery priorities, ensuring effective intake management, work prioritization, resource allocation, and coordination...Hourly payFull timeTemporary workWork experience placementLocal area- ...quo” and transform the finance industry together.The First Line Risk Management Office partners with business units to strengthen risk... ...with business stakeholders to uncover operational pain points, map current-state processes, define business and functional requirements...Full timeWork at officeWork from homeRelocationMonday to Friday
- ...Finance, People and Places, General Counsel, Risk, Internal Audit, Strategy and Development... ...& Investment (PS&SI) first line risk management program. Ensure risk considerations are embedded... ...guidance on process reviews, process mapping, control design, insufficient...Full timeContract workWork at officeRemote workWorldwideVisa sponsorship
- ...live commerce? We are seeking a strategic, committed Senior Manager, Live Risk Strategy to own and scale the end-to-end Seller Risk... ...tracking performance against plan, and making proactive policy adjustments to keep losses within acceptable thresholds.Partner with Finance...Immediate startRemote workVisa sponsorship
$157.55k - $190.91k
...practices.The Data Protection & Insider Risk Senior Specialist will be a key member of... ...background in cyber security, risk management, and compliance.This role is pivotal in... ...reviewed on an ongoing basis and may be adjusted over time to reflect evolving market factors...Hourly payFull timeSummer workLive inLocal areaRemote workFlexible hours$119.4k - $204.6k
...lead the charge to shape consumer credit risk strategy and drive sustainable growth.... ...data-driven strategies that optimize risk-adjusted returns. Collaborate cross-functionally... ...Minimum - 4 Year Bachelors Degree in Management, Business, Statistics or Related Minimum...Full timeTemporary workPart timeWork from home3 days per week- ...clean energy goals. Our experienced team manages every aspect of our operations – from power... ...a highly motivated and detail-oriented Risk Manager to support the organization’s... ...Development, Finance, insurance brokers, adjusters, and other third parties. Review and provide...Local areaRemote work
$120k - $130k
...Annually Position Summary Terra-Gen is seeking a Manager to join its Corporate Risk Management department. This is an exciting opportunity... ...claims. Coordinate with Legal, Human Resources, and adjusters throughout the claims process. Serve as the central point...Full timeContract workTemporary workWork at officeLocal area$116k - $216k
...Carolina Position Summary Will support the enterprise AI Risk Management Governance program by executing and enhancing KeyBank's AI risk... ...requirements to enterprise processes. Coordinate control mapping, gap assessments, ownership, remediation, and evidence...Full timeWork at officeRemote workWork from homeFlexible hours$121.36k - $182.04k
Director, Market Risk Mgmt - VNE67RWe’re determined to make a difference and are proud to be an insurance company that goes well beyond... ..., too. Join our team as we help shape the future. The Risk Manager, Investment Risk, will join the ALM, Credit and Market Risk team...Full timeTemporary workWork at officeRemote work$91k - $169k
...Seller Engagement partner for the Seller Risk organization, translating business priorities... ...Strategy Partner with the Senior Manager to execute the Seller Engagement strategy... ...experiences. Familiarity with customer journey mapping, communication strategy, content...Full timeTemporary workPart timeImmediate start$160k - $195k
...seeking a strategic and dynamic leader to drive the organization’s risk adjustment, clinical documentation improvement, provider engagement, and... ...will lead multiple layers of leadership, including Senior Managers, Managers, and their teams, while translating enterprise...Contract workRemote work- ...building. This position establishes business loan, deposit, treasury management and other related services to meet needs of clients within a... ...include close vision, distance vision, and the ability to adjust focus. Physical activity requiring reaching, sifting, lifting...Work at office
$100k - $140k
...lifestyles, especially when it comes to managing finances. TrueML’s approach uses machine... ...learning to engage each customer digitally and adjust strategies in real time in response to... ...Role: As the Manager, Compliance & Risk, you will serve as the operational backbone...Full timeWork at officeLocal areaRemote workFlexible hours$115k - $165k
...300,000 members across 150+ cities and puts home swapping on the map as a radically more affordable, responsible, and connected way to... ...established T&S team and deepen how we understand, anticipate, and govern risk across our marketplace. You'll be the person who turns signals...Full timeTemporary workLocal areaRemote workFlexible hours$197k - $270k
...firm can be found at .Role:The Director of Risk is a senior role within the Legal... ...for two core pillars of the firm's risk management approach: client/engagement risk, including... ...inherent and residual risk scoring, control mapping, named risk owners, mitigation plans and...Full timeContract workFor contractorsWork experience placementFor subcontractorWork at officeLocal areaRemote work$124.55k - $163.88k
The Doctors Company is seeking a Manager Alternative Risk Underwriting. This is a hybrid opportunity based at any TDCG or PRA office.The Underwriting Manager, Alternative Risk is responsible for the profitable growth, retention, and overall management of a complex portfolio...Full timeTemporary workCasual workWork at office- ...product quality assessment, consumer complaint retrieval, crisis management, and product recall execution. From concept to consumption, RQA... ..., developing, and documenting audit issues, conducting risk assessments, and proposing effective solutions. Key responsibilities...Full timeTemporary workWork experience placementWork at officeRemote workFlexible hours
$43.16 - $72.89 per hour
...Health locations periodically as business needs require. Prior risk management experience strongly preferred Risk Manager Job Code: RM... ...of quality service and meeting the needs of stakeholders. Adjusts and adapts service delivery to diverse customer needs and...Hourly payWork experience placementWork at officeLocal areaRemote workShift work$92.1k - $115k
...Join to apply for the Enterprise Risk Manager role at Subaru of America Continue with Google Continue with Google 1 day ago Be among the first... ...and presents updates on SOAR operations, risk register, heat map, dashboards, risk mitigation, and emerging exposures to SOA,...Full timeWork at officeRemote work2 days per week- ...Job Description Investor Relations Manager (LAND INVESTMENT & PRIVATE EQUITY) - \n \n LandQuire is an innovative property technology company specializing in land investment opportunities. LandQuire community members can discover or share land investment opportunities...Worldwide
- ...currently authorized to work in the United States on a full-time basis without employer sponsorship.Model Risk Oversight is a strategic function within Corporate Risk Management that uses advanced quantitative methods and a broad range of models to support innovative client...Full timeWork at officeWork from homeRelocation
$130.5k - $193.6k
...as instant access to funds and payouts. We also help merchants connect with their customers, process exchanges and returns, and manage risk. We enable consumers to engage in cross-border shopping and merchants to extend their global reach while reducing the complexity...Full timeWork at officeLocal areaImmediate startFlexible hours$167.5k - $279k
...part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Consulting Senior Manager, Banking, Risk and FSI to join our team in New York, New York (US-NY), United States (US).Location: New York, NYEmployment Type: Full-timeExperience...Full timeTemporary workWork at officeRemote workFlexible hours$101k - $203k
...both personally and professionally. There’s no one like you and that’s why there’s nowhere like RSM.The PositionAs a manager in RSM’s growing Healthcare Risk Consulting Practice, you will have the opportunity to draw from your healthcare experience and knowledge while...Full timeWork experience placementInternshipLocal areaRemote workShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Manager, Risk Adjustment MLTC-MAP. Be the first to apply!




