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Risk Adjustment Manager
Centene Corporation. Manage business processes related to risk adjustment and quality improvement across assigned products and plans .
Posted 10/6/2026full-timeRemote • Pennsylvania • United StatesMid-LevelSenior💰 $87,700 - $157,800 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing business processes related to risk adjustment and quality improvement within the healthcare industry, with a strong focus on project management and operational workflows. Proficient in developing action plans, dashboards, and evaluating strategies to enhance product performance and compliance.
Highest-signal resume keywords
Project ManagementOperations ManagementQuality ImprovementData Analysis/ReportingHealthcare Industry Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Risk Adjustment StrategyOperational WorkflowsAction Plans DevelopmentWorkplans CreationProgress ReportsIssue LogsDashboard PreparationData AnalysisQuality Improvement ProcessesHealthcare Compliance
Soft Skills
CollaborationCommunicationProblem-SolvingPartnership DevelopmentStrategic Thinking
Industry Keywords
Managed CareMedicareMLTSSClinical ExperienceSocial Work ExperienceHealth Plan InitiativesLocal Market DynamicsCompetitive LandscapesBusiness RequirementsHealthcare Products
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 affecting assigned products and plans
- Create detailed workplans, issue logs, and progress reports
- Identify and partner with departments to implement assigned product business requirements
- Develop and execute operational workflows specific to product business 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
Requirements
What you’ll need- 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
- Clinical or Social work experience preferred
- Previous managed care or Medicare experience preferred
- MLTSS experience is a plus
- Ideal candidate to live in the state of PA
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
- Benefits may be subject to program eligibility