CVS Health
Sr. Manager, Business Consultant Risk Adjustment
CVS Health, Hartford, Connecticut, us, 06112
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary
The Revenue Integrity (RI)
Sr. Manager, Business Consultant
(Risk Adjustment)
is responsible for the management and monitoring of designated market/territory specific to the performance of risk adjustment (RA). The role is responsible for all aspects of driving collaborative decision-making and implementation of corporate, regional, and local actions to maximize RA activities and initiatives for the designated market/territory. Specifically, the Business Consultant will be responsible for increasing market level engagement, collaboration, and accountability by bridging the gap between RI National and Market level resources and Programs to drive RAF results.Key Responsibilities:
Lead regular meetings with Markets to review strategy, goals, and performance holistically.Bring together national program leads and markets to calibrate interventions in response to unique market challenges and opportunities.Manage the development and implementation of corporate performance improvement campaigns and initiatives as needed.Share and promote best practices amongst market colleagues.Ensure data and reporting needs (Market Scorecard, RAD, & Supporting Data Sources) are being met to inform decisions, drive action, and measure success locally.Utilize objective data and local knowledge to create and track market specific action plans.Develop and deliver solutions that drive sustainable operating efficiency.Provide oversight and direction to markets.Provide oversight, direction, and consultative support to corporate, regional, local resources around RI programs at the National and local market level to drive strategy and make impact with our RA activities.Other responsibilities as deemed necessary by department leadership.Required Qualifications
3-5 years of Risk Adjustment experience in Medicare, IFP, and/or Medicaid.Core understanding of Risk Adjustment operations.Experience in management consulting, business process consulting, and/or strategic business planning.Well versed in Microsoft Office Suite.Preferred Qualifications
SAS/SQL experience.Education
Bachelor's degree or 7 years of equivalent work experience.Pay Range
The typical pay range for this role is: $79,200.00 - $174,200.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits .We anticipate the application window for this opening will close on: 03/15/2024.CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through
ColleagueRelations@CVSHealth.com . If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
#J-18808-Ljbffr
The Revenue Integrity (RI)
Sr. Manager, Business Consultant
(Risk Adjustment)
is responsible for the management and monitoring of designated market/territory specific to the performance of risk adjustment (RA). The role is responsible for all aspects of driving collaborative decision-making and implementation of corporate, regional, and local actions to maximize RA activities and initiatives for the designated market/territory. Specifically, the Business Consultant will be responsible for increasing market level engagement, collaboration, and accountability by bridging the gap between RI National and Market level resources and Programs to drive RAF results.Key Responsibilities:
Lead regular meetings with Markets to review strategy, goals, and performance holistically.Bring together national program leads and markets to calibrate interventions in response to unique market challenges and opportunities.Manage the development and implementation of corporate performance improvement campaigns and initiatives as needed.Share and promote best practices amongst market colleagues.Ensure data and reporting needs (Market Scorecard, RAD, & Supporting Data Sources) are being met to inform decisions, drive action, and measure success locally.Utilize objective data and local knowledge to create and track market specific action plans.Develop and deliver solutions that drive sustainable operating efficiency.Provide oversight and direction to markets.Provide oversight, direction, and consultative support to corporate, regional, local resources around RI programs at the National and local market level to drive strategy and make impact with our RA activities.Other responsibilities as deemed necessary by department leadership.Required Qualifications
3-5 years of Risk Adjustment experience in Medicare, IFP, and/or Medicaid.Core understanding of Risk Adjustment operations.Experience in management consulting, business process consulting, and/or strategic business planning.Well versed in Microsoft Office Suite.Preferred Qualifications
SAS/SQL experience.Education
Bachelor's degree or 7 years of equivalent work experience.Pay Range
The typical pay range for this role is: $79,200.00 - $174,200.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits .We anticipate the application window for this opening will close on: 03/15/2024.CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through
ColleagueRelations@CVSHealth.com . If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
#J-18808-Ljbffr