CVS Health · 8 hours ago
Senior Manager, Revenue Integrity Medicare Strategic Programs
United States
Full-time
Remote
Senior Level
$68K/yr - $199K/yr
5+ years expCVS Health is committed to building a world of health around every individual. The Senior Manager will work closely with various Lead Directors and subject matter experts to establish market level revenue integrity excellence, focusing on risk adjustment activities and process improvements.
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Responsibilities
Develop & execute strategies to enhance risk adjustment performance and meet organizational goals
Own, maintain, and develop Medicare PMO reporting and related artifacts
Collaborate cross functionally to support and maintain Medicare PMO goal setting and budget/forecast processes
Strategize on program improvement opportunities in conjunction with Medicare Analytics team to identify and implement data enhancements and resolve issues
Assemble and analyze data to produce Medicare reporting specific to Revenue Integrity efforts for various governance, market, and executive leadership meetings
Collaborate with market leads to identify and recommend nuanced market risk adjustment strategies and collaboratively executing tactics to focus, maximize and achieve market success
Communicate effectively with internal teams, health plan executives, and external stakeholders on risk adjustment matters
Support the development of clear and concise communication materials related to risk adjustment initiatives
Foster a culture of awareness and understanding regarding the importance of risk adjustment across the organization
Recruit, develop and retain a high performing, high quality risk adjustment talent pool that is respected within Medicare operations
Develop the skills and abilities of all team members to optimize their performance and create succession plans for future leaders that can take on roles with increasing responsibilities
Monitor industry trends and best practices to inform continuous improvement initiatives
Qualification
Required
A minimum of 5 years of experience with Medicare Risk Adjustment
A minimum of 2 years of data analytics experience, using data to tell a story
Proven ability to manage multiple projects simultaneously and meet deadlines
Ability to manipulate the data using Microsoft Excel
Preferred
Proven ability to develop, structure, and deliver high‑quality executive presentations that communicate complex information with clarity, precision, and strategic insight
Demonstrated experience presenting to senior leadership and C‑suite audiences, utilizing strong data storytelling, visual design standards, and executive‑level communication skills to support decision‑making and influence business outcomes
Bachelor's Degree preferred or a combination of equivalent work experience and education
Benefits
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
2026-01-25
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