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Senior Manager, Medicaid Risk Adjustment
CVS Health. Drive market-level engagement for Medicaid Risk Adjustment programs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicaid Risk Adjustment programs, with a strong ability to translate performance data into actionable insights and drive market-level engagement. Proven leadership in managing cross-functional initiatives and delivering measurable impact through effective communication and stakeholder collaboration.
Highest-signal resume keywords
Medicaid Risk AdjustmentCross-Functional Initiative ManagementData Analysis and Performance MetricsTeam Leadership and DevelopmentHealth Care Operations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Project ManagementBusiness OperationsPerformance Metrics AnalysisClaims Denial ResolutionRevenue Integrity
Soft Skills
Excellent CommunicationPresentation SkillsAnalytical Problem-SolvingFacilitation SkillsTeam Accountability
Tools & Technologies
DashboardsReports
Certifications & Qualifications
Risk Adjustment Certification
Industry Keywords
Health Care AdministrationInsurance Regulatory RequirementsProvider EngagementMarket EngagementStakeholder Management
About the role
Key responsibilities & impact- Drive market-level engagement for Medicaid Risk Adjustment programs
- Deliver insights and demonstrate the value of Medicaid risk adjustment performance to senior leaders and market partners
- Connect national Risk Adjustment strategy with market execution
- Ensure alignment, accountability, and measurable impact
- Lead territory and market-level meetings
- Oversee a team of managers responsible for delivering market engagement
- Facilitate tactical working sessions and process next steps
- Translate performance data into actionable insights
- Collaborate with cross-functional partners to advance claims denial resolution, provider engagement opportunities, and member outcomes
Requirements
What you’ll need- 5+ years of business, operations, project management, or program management experience
- 3+ years of experience managing cross-functional initiatives, deliverables, timelines, and stakeholder follow-up
- 2+ years of experience in Medicaid, health care operations, risk adjustment, revenue integrity, claims, provider engagement, or related health care programs
- Experience using data, dashboards, reports, or performance metrics to identify opportunities and support business decisions
- Experience preparing and presenting business updates or recommendations to leadership or cross-functional stakeholders
- Experience facilitating meetings or working sessions with defined action items, owners, and timelines
- Knowledge of insurance regulatory and contractual requirements
- Excellent communication and presentation skills, including presentation to executive leadership
- Strong analytical and problem-solving skills
- Ability to lead projects end to end
- Ability to lead, coach, and develop managers while driving team accountability, prioritization, and execution across multiple markets
- Bachelor’s degree in Finance or Health Care Administration required, or 3+ years of relevant work experience in lieu of degree
- Previous work in Risk Adjustment and/or Medicaid and certification preferred
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program
- Award target in the company’s equity award program
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility