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Centene Corporation

Manager, Risk Adjustment

Centene Corporation

. Manage business processes related to risk adjustment and quality improvement across assigned products and plans .

Posted 11/3/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $87,700 - $157,800 per yearWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing risk adjustment and quality improvement processes within the healthcare industry, with a strong focus on operational workflows and team leadership. Proficient in developing action plans and dashboards to enhance business performance and support health plan initiatives.

Highest-signal resume keywords
Risk Adjustment ProgrammingProject ManagementQuality ImprovementTeam LeadershipHealthcare Industry Experience

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Risk Adjustment StrategyData AnalysisOperational WorkflowsBusiness Process ManagementAction Plan Development
Soft Skills
Strong Analytical SkillsPresentation SkillsMultitasking AbilityLeadership Skills
Tools & Technologies
DashboardsIssue LogsProgress Reports
Certifications & Qualifications
CPCCPC-HCPC-PCRCCCSCCS-PRHITRHIACPMA
Industry Keywords
Managed CareMedicareHealthcare Quality ImprovementBusiness RequirementsProvider Network

About the role

Key responsibilities & impact
  • Manage business processes related to risk adjustment and quality improvement across assigned products and plans
  • Develop and implement action plans across departments to address business-unit issues
  • Create detailed workplans, issue logs and progress reports
  • Identify and partner with departments to implement business requirements for assigned products
  • Develop and execute operational workflows tailored to product requirements, competitive landscapes and local market dynamics
  • Evaluate and manage risk adjustment strategy across functional areas impacting assigned products
  • Identify and support health plan initiatives related to assigned products
  • Prepare dashboards for senior management and identify improvement opportunities
  • Lead a team of 7 direct reports in AZ and NV

Requirements

What you’ll need
  • One of the following certifications required at time of hire: CPC, CPC-H, CPC-P, CRC, CCS, CCS-P, RHIT, RHIA or CPMA
  • CRC required within the first year of employment
  • CPMA preferred on the second year of employment
  • Ability to lead a team of 7 direct reports in AZ and NV
  • Strong analytical skills
  • Ability to multitask and pivot
  • Strong understanding of coding and risk adjustment programming
  • Strong presentation skills with leadership and provider network
  • Bachelor’s degree in related field or equivalent experience
  • 4+ years of project management, operations, quality improvement or data analysis/reporting experience in the healthcare industry
  • Previous managed care or Medicare experience preferred

Benefits

Comp & perks
  • Competitive pay
  • Health insurance
  • 401K
  • 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 and diversity commitment