Job Overview
Location
Remote-FL
Job Type
Full-time
Category
HR & Recruiting
Date Posted
May 10, 2026
Full Job Description
đź“‹ Description
- • Provide operational leadership for Centene's Corporate Risk Adjustment program operations and its subsidiaries, overseeing compliance with Risk Adjustment data integrity and validation audit processes to ensure accurate and timely reporting for 28 million members.
- • Lead enterprise-wide Risk Adjustment operations for coding and external audits, ensuring consistent execution while addressing market, product, and regulatory variation; oversee encounter data submissions and reconciliation to ensure data completeness, accuracy, and regulatory alignment.
- • Lead and develop high performing, multi-disciplinary teams through complex change, reinforcing accountability, engagement, and results; establish strong governance and oversight for Risk Adjustment compliance, including RADV and other regulatory and internal audits.
- • Drive enterprise change management through standardized processes, tools, and controls that improve scalability, quality, and compliance; effectively communicate risk, organizational impact and progress towards achieving goals; ensure disciplined oversight of vendor performance, holding partners accountable to quality, timeliness, and contractual expectations.
🎯 Requirements
- • 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.
🏖️ Benefits
- • Competitive pay within the range of $188,900.00 - $359,800.00 per year, adjusted based on skills, experience, education, and other job-related factors.
- • Comprehensive benefits package including health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays.
- • Flexible approach to work with remote, hybrid, field or office work schedules.
- • Additional forms of incentives may be included in total compensation.
Skills & Technologies
About Centene Corporation
Centene Corporation is a publicly traded managed-care enterprise that arranges health-benefit programs for government-sponsored and privately insured individuals. Operating across all 50 U.S. states and internationally, the company focuses on under-insured and uninsured populations through Medicaid, Medicare, and Marketplace offerings. Its services include behavioral health, pharmacy benefits, vision, dental, telehealth, and in-house clinical programs. Centene partners with physicians, hospitals, and community organizations to coordinate cost-effective care, emphasizing data analytics and value-based reimbursement models. Headquartered in St. Louis, Missouri, it serves more than 25 million members, positioning itself as a leading intermediary between payers and healthcare providers.
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