Medicare Risk Adjustment Manager (Southeast)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

This is an individual contributor role.

As the Manager, Risk Adjustment will be responsible for leading Risk Adjustment for the Southeast Region, specifically in GA/Gulf States. This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key value-based providers. The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical record collection, provider collaboration and data sharing, general coding education and related activities, as well as other activities as assigned. This position requires someone who can think strategically and act independently when working with providers. This position reports to the Lead Director of Risk Adjustment for the Southeast Region.

Required Qualifications

• 5+ years of experience with one or more of the following methodologies: risk adjustment, clinical quality, or healthcare quality improvement.
• Certification in coding (CPC, CRC, RHIA, etc. through AAPC or AHIMA).
• Experience working in provider offices, accountable care organizations and / or value-based provider relations.
• Strong time management, project management, change management, organizational, research, analytical, negotiation, communication, and interpersonal skills.
• Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web-based meetings.
• Must be able to manage ambiguity and work in fast paced environment.
• Excellent stakeholder relationship management skills.

Preferred Qualifications

• 7+ years of experience in risk adjustment, clinical quality, or healthcare quality improvement required; experience supporting provider‑based or value‑based initiatives preferred.
• Candidates residing in Georgia or the Southeastern United States are preferred.

Education

• Bachelor’s degree preferred, or a combination of relevant professional experience and education.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $119,340.00

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/08/2026

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