Risk Adjustment Specialist (Clinical)
Centene Corporation•Remote-PA, PA
•$56,200 - $101,000•Remote
About The Position
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Requirements
- RN License
- Clinical and/or Quality Improvement and HEDIS experience is required.
- Bachelor’s degree or equivalent experience.
- 2 years of quality improvement or clinical experience required.
Nice To Haves
- Bachelor’s degree in nursing
- experience in managed care industry
Responsibilities
- Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management related to those initiatives
- Help train providers and Health Plan staff in Risk Adjustment methodologies and activities to continue to improve Centene’s Risk Adjustment score – some travel maybe required
- Research and assist in development of best practices into operations for Risk Adjustment
- Prepare operational workflows specific to each product business requirements and the local market dynamics
- Prepare and participate in meetings with various committees and providers
- Performs other duties as assigned
- Complies with all policies and standards
Benefits
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
