Vice President, Risk Adjustment Program Operations & Data Integrity

Centene

Base: $188,900.00 - $359,800.00 py; bonus/equity: ...
Hybrid
10+ years progressive leadership experience
Deep knowledge of cms risk adjustment requirements
Expertise in radv audits and icd-10 cm coding standards
Centene is seeking a Vice President of Risk Adjustment Program Operations & Data Integrity to lead their corporate risk adjustment operations and ensure compliance with regulatory standards. The ideal candidate will have extensive experience in healthcare risk adjustment, coding, and team leadership, along with a commitment to improving community health outcomes

Job Summary

  • This executive role provides operational leadership for Centene's Corporate Risk Adjustment program across its subsidiaries and markets.
  • The position requires overseeing compliance with data integrity validation audits, RADV requirements, and encounter data submissions.
  • Centene offers a comprehensive benefits package including competitive pay ranging from $188,900 to $359,800, 401K, and flexible work schedules.

Matching Summary

Match Score: 85

Centene is seeking a Vice President of Risk Adjustment Program Operations & Data Integrity to lead their corporate risk adjustment operations and ensure compliance with regulatory standards. The ideal candidate will have extensive experience in healthcare risk adjustment, coding, and team leadership, along with a commitment to improving community health outcomes.

Salary

Base: $188,900.00 - $359,800.00 per year; Bonus/Equity: Additional incentives may apply; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off

Skills & Requirements

Must-have

  • 10+ years progressive leadership experience
  • Deep knowledge of CMS Risk Adjustment requirements
  • Expertise in RADV audits and ICD-10 CM coding standards
  • Experience leading large teams of coders and auditors
  • Proven record establishing coding governance programs

Nice-to-have

  • Advanced degree in health information management
  • Experience with enterprise change management
  • Strong stakeholder communication skills
  • Ability to drive standardized processes and controls

Key Requirements

  • Bachelor's degree required; advanced degree preferred
  • 10+ years of leadership in Risk Adjustment or medical coding
  • Demonstrated experience leading multi-disciplinary teams
  • Deep knowledge of regulatory environments and audit readiness

Work Rights

Not specified

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