Risk Adjustment Program Manager

Posted:
8/12/2024, 5:00:00 PM

Location(s):
Connecticut, United States ⋅ Hartford, Connecticut, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Business & Strategy ⋅ Data & Analytics ⋅ Product

Workplace Type:
Hybrid

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
 

Position Summary
**This role is a Hybrid role which means a hybrid Colleague works some of their scheduled workdays each week in an assigned company office location, and some workdays from home.


Aetna has an exciting opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP lines of business! In this role you will serve as a hybrid project manager and subject matter expert in  Risk Adjustment chart retrieval & coding programs and related analytics and reporting.

 

Your will be responsible for provider/vendor/network outreach, production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP lines of business.. You will also perform statistical analyses to generate risk adjustment reporting and provide data-driven insights.  Join this exciting opportunity to work directly with different teams across the organization and have a meaningful impact on our business!


Successful candidates will possess the following abilities:

-Data analysis and interpretation

-Applying judgement and identify solutions

-Strong technical skills

- Excellent communication and negotiation skills

- Willing to probe into technical & workflow details and problem solve
- Build and improve processes
- Juggle multiple priorities
- Be organized and exhibit attention to detail

Position Summary
**This role is a Hybrid role which means a hybrid Colleague works some of their scheduled workdays each week in an assigned company office location, and some workdays from home.


Aetna has an exciting opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP lines of business! In this role you will serve as a hybrid project manager and subject matter expert in  Risk Adjustment chart retrieval & coding programs and related analytics and reporting.

 

Your will be responsible for provider/vendor/network outreach, production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP lines of business.. You will also perform statistical analyses to generate risk adjustment reporting and provide data-driven insights.  Join this exciting opportunity to work directly with different teams across the organization and have a meaningful impact on our business!


Required:

3+ years Data analysis and interpretation

Applying judgement and identify solutions

Advanced Microsoft Excel, SAS skills

Advanced skills in turning data into information and apply judgment.
3+ years Delivering Profit and Performance

Willing to probe into technical & workflow details and problem solve

Build and improve processes
-Be organized and exhibit attention to detail


Education
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

Pay Range

The typical pay range for this role is:

$54,300.00 - $139,200.00

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. 
 
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: 09/08/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.