Manager, Compliance Risk Adjustment

Centene Corporation

. Manage a team responsible for facilitating and leading external audits related to Risk Adjustment processes .

Posted 10/6/2026full-timeRemote • United StatesMid-LevelSenior💰 $87,700 - $157,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing external audits related to Risk Adjustment processes, ensuring compliance with regulatory standards, and delivering accurate audit documentation. Proven ability to collaborate with stakeholders to enhance operational efficiency and implement corrective action plans.

Highest-signal resume keywords

External Audit ManagementRisk Adjustment ComplianceAudit Documentation Quality ReviewCorrective Action Plan DevelopmentRegulatory Agency Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Audit ManagementRisk Adjustment ProcessesCompliance OversightQuality Improvement InitiativesData AnalysisReport PreparationRegulatory ComplianceRisk ManagementOperational EfficiencyBest Practices Research

Soft Skills

CollaborationCommunicationProblem-SolvingStakeholder EngagementLeadership

Certifications & Qualifications

Active Coding Credential from AHIMA or AAPCCPMARHIARHITRisk Adjustment Credential

Industry Keywords

Risk AdjustmentExternal AuditsMedicareRegulatory LandscapeCompliance Issues

About the role

Key responsibilities & impact

Manage a team responsible for facilitating and leading external audits related to Risk Adjustment processes
Ensure visibility through reporting audit deliverables and associated risks for each audit
Collaborate with business areas to prevent, detect, and correct compliance issues identified in external audits
Serve as point of contact for external audits and correspond with auditors regarding acknowledgements, deliverable timelines, and inquiries
Manage submission of external audit deliverables and respond timely to state and federal regulatory agencies
Quality review external audit deliverables for completeness and accuracy before submission
Communicate with internal and external audit partners to clarify deliverables, requirements, and deadlines
Serve as subject matter expert on external audit processes, policies, and quality improvement initiatives
Socialize identified risks with internal partners and enter Corrective Action Intake
Support Corrective Action Plan development and review before submission to external auditors
Maintain detailed audit documentation, including meeting minutes, action items, identified issues, and risk management plans
Prepare and present reports to stakeholders on risk adjustment audit performance and progress
Support strategy development to improve risk adjustment accuracy and operational efficiency
Provide operational and analytical support to the Risk Adjustment department
Research and recommend best practices for continuous improvement in risk adjustment
Perform other duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

Bachelor's Degree in Audit, Compliance, Legal, or related field or equivalent experience required
5+ years Audit, risk adjustment and/or compliance required
Previous experience in risk adjustment oversight and/or coding planning preferred
Demonstrated understanding of risk adjustment regulatory landscape preferred
Risk Adjustment regulatory audit experience preferred
Medicare experience preferred
Active Coding Credential from AHIMA or AAPC preferred
CPMA, RHIA, RHIT or Risk Adjustment Credential preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
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
Equal opportunity employer committed to diversity