Note: The job is a remote job and is open to candidates in USA. Centene Corporation is transforming the health of communities, and they are seeking a Vice President to lead their Corporate Risk Adjustment program operations. The role involves overseeing compliance, managing enterprise-wide operations, and ensuring data integrity and quality across various healthcare initiatives.
Responsibilities
- Lead enterprise-wide Risk Adjustment operations for coding and external audits, ensuring consistent execution while addressing market, product, and regulatory variation
- Lead and develop high performing, multi-disciplinary teams through complex change, reinforcing accountability, engagement, and results
- Drive enterprise change management through standardized processes, tools, and controls that improve scalability, quality, and compliance
- Oversee encounter data submissions and reconciliation to ensure data completeness, accuracy, and regulatory alignment
- Effectively communicate risk, organizational impact and progress towards achieving goals
- Establish strong governance and oversight for Risk Adjustment compliance, including RADV and other regulatory and internal audits
- Work with local market teams as necessary to support Enterprise Risk Adjustment programs and education
- Ensure disciplined oversight of vendor performance, holding partners accountable to quality, timeliness, and contractual expectations
- Performs other duties as assigned
- Complies with all policies and standards
Skills
- Bachelor's degree in health information management, Nursing, Healthcare Administration, Business, or related field required, advanced degree preferred
- 10+ years of progressive leadership experience in Risk Adjustment, medical coding, healthcare compliance, or related regulated healthcare operations
- Demonstrated experience leading large teams of certified coders, auditors, and quality professionals across multiple programs or markets
- Deep knowledge of CMS Risk Adjustment requirements, ICD 10 CM coding standards, RADV audits, and encounter data submissions
- Proven record of establishing coding governance, quality assurance, and audit readiness programs in highly regulated environments
- Executive level people leadership experience, including workforce development, performance management, and leading teams through change
- Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- A flexible approach to work with remote, hybrid, field or office work schedules
- Total compensation may also include additional forms of incentives
- Benefits may be subject to program eligibility
Company Overview
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives. It was founded in 1984, and is headquartered in St Louis, Missouri, USA, with a workforce of 10001+ employees. Its website is http://centene.com.