Manager, W&E Professional Coding

CVS Health

. Lead, coach, and develop Certified Coding Analysts and Senior Certified Coding Analysts .

Posted 9/22/2026full-timeUnited StatesMid-LevelSenior💰 $60,300 - $145,860 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in medical coding and auditing, with a strong focus on compliance with CPT, HCPCS, ICD-10, and CMS requirements. Proven ability to lead teams, manage performance, and drive operational improvements through data analysis and quality oversight.

Highest-signal resume keywords

AAPC Certified Coder CPCMedical Coding ExperiencePeople Leadership ExperienceCPT, HCPCS, ICD-10 KnowledgeMicrosoft Excel Proficiency

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Medical CodingClaims ReviewAuditingCoding CompliancePerformance ManagementQuality ProgramsData AnalysisWorkload OversightTargeted RemediationRegulatory Compliance

Soft Skills

CoachingCommunicationProblem SolvingTeam ManagementPresentation Skills

Tools & Technologies

Microsoft ExcelMicrosoft Word

Certifications & Qualifications

AAPC Certified Coder CPCCCSRHITRN License

Industry Keywords

CPTHCPCSICD-10CMS 1500UB-04FraudWasteAbuseOperational OversightQuality Review Processes

About the role

Key responsibilities & impact

Lead, coach, and develop Certified Coding Analysts and Senior Certified Coding Analysts
Establish role expectations, performance goals, productivity standards, quality requirements, and accountability measures
Oversee hiring, onboarding, training, succession planning, engagement, and retention
Provide operational oversight for medical record reviews, coding audits, reconsiderations, appeals, and waste and error activities
Assign priorities and manage work queues to meet production, turnaround time, quality, and service-level expectations
Monitor workload, staffing capacity, inventory, aging, productivity, and resource allocation
Ensure accurate application of CPT, HCPCS, ICD-10, modifier, CMS, state, federal, and organizational requirements
Oversee escalations for complex coding questions, policy interpretation, Medical Director review, and case decisions
Establish and monitor quality review processes; implement coaching, training, and corrective action plans
Maintain compliance with state, federal, contractual, accreditation, and organizational requirements
Support internal and external audits, regulatory reviews, and documentation requests
Develop and monitor KPIs for productivity, quality, inventory, turnaround time, savings, and operational outcomes
Analyze performance, coding trends, billing issues, and root causes to identify improvements
Present operational updates, performance results, risks, decisions, and recommendations to leadership and business partners
Drive process standardization, workflow improvements, automation, system enhancements, and resource optimization
Participate in system implementations, upgrades, pilots, and new program launches
Collaborate with Senior Leadership, Medical Directors, Legal, Compliance, Analytics, Operations, Technology, and Payment Integrity partners
Serve as management escalation point for complex cases, operational barriers, coding disputes, and stakeholder concerns
Represent the Waste & Error coding team in governance meetings, business reviews, implementations, and strategic initiatives

Requirements

What you’ll need

Active AAPC Certified Coder CPC, CCS, RHIT or RN license with significant coding/auditing experience may be considered
5+ years of experience in medical coding, claims review, auditing, payment integrity, fraud, waste, abuse, or error review
2+ years of people leadership, supervisory, or team management experience, including performance management, coaching, and employee development
Experience leading coding quality programs, productivity management, workload oversight, and targeted remediation activities
Strong knowledge of CPT, HCPCS, ICD-10, CMS 1500, UB-04, coding compliance, and reimbursement requirements
Experience researching and applying state, federal, CMS, and organizational policies
Ability to manage multiple priorities, resolve complex issues, and meet operational deadlines
Strong written and verbal communication skills, including presenting performance results and case decisions to internal and external stakeholders
Proficiency with Microsoft Excel and Word; ability to interpret operational and quality data
High school diploma or GED
Hybrid policy may require onsite work three days a week for in-scope hires living near a suitable work location

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Hybrid work environment, subject to policy and location eligibility