Hispanic Alliance for Career Enhancement
Risk Adjustment Outreach Manager
Hispanic Alliance for Career Enhancement, Phoenix, Arizona, United States
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues — caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
A Brief Overview In this role, you will manage large-scale projects, analyze performance data, and collaborate with key stakeholders. You will build vendor relationships and engage providers to drive successful chart retrieval efforts and achieve organizational goals.
What you will do
Project Leadership:
Manage assigned territory within the risk adjustment program from planning through completion, including leading cross-functional meetings, setting timelines, and tracking progress.
Chart Retrieval Oversight:
Ensure timely and accurate chart retrieval by managing processes, resolving barriers, and maintaining compliance.
Provider Engagement:
Conduct outreach to providers to address retrieval challenges and negotiate fees when necessary.
Data Retrieval & Entry:
Extract data from vendor portals and update designated spreadsheets, ensuring accuracy and timeliness.
Vendor Management:
Build and maintain vendor relationships, monitor performance and risks.
Data Analysis & Reporting:
Analyze data to identify trends and develop actionable insights for program optimization. Present findings to senior leadership and external stakeholders.
Performance Monitoring:
Track and report on key metrics to ensure retrieval targets and internal benchmarks are consistently achieved.
Cross-Functional Collaboration:
Partner with Market/Network teams and Provider Relations to align initiatives with organizational objectives.
For this role you will need Minimum Requirements
5-7 years of professional experience, preferably in healthcare operations, risk adjustment, or related fields.
Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, data analysis, reporting).
Strong analytical, problem-solving, and project management skills.
Ability to work independently and manage priorities with minimal supervision.
Excellent verbal and written communication skills.
Proven ability to build relationships and collaborate across teams.Experience managing complex territories and cross-functional projects.
Preferred Qualifications
Experience in risk adjustment, vendor management, and program management.
Familiarity with systems and tools used for chart retrieval and retrospective operations.
Negotiation skills and experience resolving provider participation barriers.
Education
Bachelor's degree or an equivalent combination of education and experience will be considered.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range Typical pay range: $60,300.00 - $132,600.00. The actual base salary offer will depend on experience, education, geography and other factors. Eligible for bonus, commission or short-term incentive program.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits — investing in the well‑being of colleagues and their families. Benefits include:
Affordable medical plan options , a
401(k) plan
(including company matching), and an
employee stock purchase plan .
No‑cost programs for all colleagues
such as wellness screenings, tobacco cessation, weight management, confidential counseling and financial coaching.
Benefit solutions addressing different needs
including paid time off, flexible schedules, family leave, dependent care resources, peer assistance programs, tuition assistance, retiree medical access, and more.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
Application window closes on: 01/12/2026.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr
A Brief Overview In this role, you will manage large-scale projects, analyze performance data, and collaborate with key stakeholders. You will build vendor relationships and engage providers to drive successful chart retrieval efforts and achieve organizational goals.
What you will do
Project Leadership:
Manage assigned territory within the risk adjustment program from planning through completion, including leading cross-functional meetings, setting timelines, and tracking progress.
Chart Retrieval Oversight:
Ensure timely and accurate chart retrieval by managing processes, resolving barriers, and maintaining compliance.
Provider Engagement:
Conduct outreach to providers to address retrieval challenges and negotiate fees when necessary.
Data Retrieval & Entry:
Extract data from vendor portals and update designated spreadsheets, ensuring accuracy and timeliness.
Vendor Management:
Build and maintain vendor relationships, monitor performance and risks.
Data Analysis & Reporting:
Analyze data to identify trends and develop actionable insights for program optimization. Present findings to senior leadership and external stakeholders.
Performance Monitoring:
Track and report on key metrics to ensure retrieval targets and internal benchmarks are consistently achieved.
Cross-Functional Collaboration:
Partner with Market/Network teams and Provider Relations to align initiatives with organizational objectives.
For this role you will need Minimum Requirements
5-7 years of professional experience, preferably in healthcare operations, risk adjustment, or related fields.
Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, data analysis, reporting).
Strong analytical, problem-solving, and project management skills.
Ability to work independently and manage priorities with minimal supervision.
Excellent verbal and written communication skills.
Proven ability to build relationships and collaborate across teams.Experience managing complex territories and cross-functional projects.
Preferred Qualifications
Experience in risk adjustment, vendor management, and program management.
Familiarity with systems and tools used for chart retrieval and retrospective operations.
Negotiation skills and experience resolving provider participation barriers.
Education
Bachelor's degree or an equivalent combination of education and experience will be considered.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range Typical pay range: $60,300.00 - $132,600.00. The actual base salary offer will depend on experience, education, geography and other factors. Eligible for bonus, commission or short-term incentive program.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits — investing in the well‑being of colleagues and their families. Benefits include:
Affordable medical plan options , a
401(k) plan
(including company matching), and an
employee stock purchase plan .
No‑cost programs for all colleagues
such as wellness screenings, tobacco cessation, weight management, confidential counseling and financial coaching.
Benefit solutions addressing different needs
including paid time off, flexible schedules, family leave, dependent care resources, peer assistance programs, tuition assistance, retiree medical access, and more.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
Application window closes on: 01/12/2026.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr