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Added 1 min ago
External Communications Consultant
Conduent
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The Senior Manager, Public Relations & External Communications will lead the day-to-day execution of Conduent’s public relations program, developing compelling storylines, building…
Added 11 mins ago
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Added 12 mins ago
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Partner with senior leadership to execute strategic initiatives, culinary programs, and company objectives.
Added 12 mins ago
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Manager, Talent & Organizational Development
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Sr. Manager, Security Operations
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Added 15 mins ago
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Principal Technical Product Manager, Data & Platform
GE Aerospace
Trenton, NJ
- $152,000 to $222,000 USD / year
…Defense & Systems (D&S) business, the Principal Technical Product Manager, Data & Platform owns the D&S Palantir Foundry environment and leads delivery across the technical teams that build…
Added 15 mins ago
Informatics Manager - Risk Adjustment
CVS Health
Trenton, NJ
…valuation of vendors serving Medicare and Medicaid risk adjustment programs. The position evaluates vendor capabilities and performance, develops financial and return-on-investment…
Added 15 mins ago
Data Center Facility Operations Area Director
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Meta is seeking a Senior Director to lead Data Center Facility Operations across a multi-area region, including operating campuses and future sites that are yet to be announced or built.…
Added 15 mins ago
Senior Director, Revenue Enablement (Onsite)
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…design, launch, and scale Uniphore's global Revenue Enablement program from the ground up, equipping every seller, manager, and partner to win in a fast-moving AI market. This is a hands-on…
Added 17 mins ago
Senior Digital Content Manager
US Offices & Unit
NY · Philadelphia, PA
…Asia, Europe, and the Middle East, is seeking to hire a global Senior Digital Content Manager. Reporting to the Senior Digital Marketing Manager, the Senior Digital Content Manager will…
Added 30 mins ago
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Manager, Enterprise PMO
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- $120,400 to $180,600 USD / year
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Added 30 mins ago
R-565033 Software Engineer Senior Manager - Cross Channel Banker Platform
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Added 33 mins ago
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Program Officer, Catalyst
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Remote, United States
- $65,000 to $85,000 USD / year
…work across multiple initiatives. This role reports to the Senior Program Officer for Catalyst and will work closely with teams across Switchboard and the…
Added 34 mins ago
Software Engineer II
Western Governors University
Salt Lake City, UT
Technical interview with a Senior Software Engineer and Manager, Software Engineering
Added 34 mins ago
Software Engineer II
Western Governors University
Salt Lake City, UT
Technical interview with a Senior Software Engineer and Manager, Software Engineering
Added 34 mins ago
Senior Software Engineer
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Technical Interview with a Senior Software Engineer and Manager, Software Engineering
Added 34 mins ago
Senior Compensation Partner- AI Enablement & Integration
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Added 34 mins ago
Associate Software Engineer
Western Governors University
Salt Lake City, UT
Technical Interview with a Senior Software Engineer and Manager, Software Engineering
Added 35 mins ago
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Manager, Software Development
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United States
- $144,600 to $241,100 USD / year
The Washington Post is seeking a Manager, Software Development to lead the engineering team responsible for our iOS app, the foundation for personalization, ads, sections, articles, App…
Added 45 mins ago
Manager of Tours, Hosting & Protocol
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Added 52 mins ago
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Program Manager - Retention
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- $106,200 to $140,000 USD / year
The Program Manager - Retention serves as the retention lead for an assigned portfolio of markets, translating member feedback, disenrollment trends, and market performance insights into…
Added 1 hour ago
Senior Manager, Global Strategic Orchestration – Commercial IT
Mylan Inc.
Remote, United States
Every day, we rise to the challenge to make a difference and here’s how the Senior Manager, Global Strategic Orchestration – Commercial IT will make an impact:

CVS Health

Informatics Manager - Risk Adjustment

Trenton, NJ, United States

$60,300.00 - $145,860.00

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Job details

Pay: $60,300.00 - $145,860.00
Posting language: English
Posted: Nov 6, 2026

Original job description

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.

Job Description Summary

In this role, you will support the strategy, oversight, and valuation of vendors serving Medicare and Medicaid risk adjustment programs. The position evaluates vendor capabilities and performance, develops financial and return-on-investment analyses, and uses data to forecast revenue impact and identify risks and opportunities. It partners with business, technical, and regional stakeholders to translate risk adjustment requirements into effective vendor solutions, governance routines, and performance measures. The role also presents valuation findings, recommendations, and escalation items to senior leaders while promoting compliant, accountable, and analytically driven decision-making.

What you will do

Support vendor management teams and regional stakeholders with vendor strategy, selection, contracting, onboarding, performance management, and issue resolution for Medicare and Medicaid risk adjustment programs
Develop and maintain vendor valuation methodologies that quantify financial opportunity, return on investment, operational impact, and performance against contractual commitments
Evaluate vendor capabilities, data quality, coding accuracy, submission readiness, scalability, and alignment with enterprise risk adjustment objectives
Establish scorecards, key performance indicators, and governance routines to monitor vendor performance
Use technology and programing skillsets to oversee data, reporting, and analytics needed to assess risk adjustment performance, forecast revenue impact, reconcile results, and identify emerging opportunities or risks
Translate Medicare and Medicaid risk adjustment requirements into clear business, data, and technology specifications for internal teams and external vendors
Develop, maintain, and execute analytics and AI-enabled capabilities that improve vendor oversight, valuation accuracy, operational efficiency, and decision-making while maintaining accountability
Design and maintain documentation for vendor processes, data flows, and valuation models
Present vendor performance, valuation findings, recommendations, and escalation items to senior leaders and governance forums

Required Qualifications

3+ years of relevant experience in healthcare analytics, risk adjustment, vendor management, financial analysis, or an equivalent combination of experience
Working knowledge of Medicare Advantage, Medicare Part D, Medicaid, and state-specific risk adjustment programs
2+ years of experience with SQL and/or Python for data analysis, validation, reconciliation, and performance measurement
2+ years of experience with business intelligence reporting tools such as Amazon Quick, Tableau, or Power BI
Strong problem-solving, decision-making, planning, execution, collaboration, and stakeholder management skills

Preferred Qualifications

Experience with Medicare Advantage, Part D, Medicaid, or state risk adjustment models, data submissions, reconciliation, and revenue forecasting
Experience evaluating and managing risk adjustment vendor performance
Experience developing vendor valuations, financial forecasts, sensitivity analyses, and return-on-investment assessments
Experience with contract performance measures, procurement processes, vendor scorecards, and executive governance
Experience using governed analytics or AI-enabled capabilities to improve risk adjustment operations, valuation, or vendor oversight
Experience with cloud platforms such as Amazon Web Services (AWS) and Google Cloud Platform (GCP)
Experience working with Databricks to query data, develop analysis, and deploy dashboards

Education

Bachelor's degree preferred/specialized training/relevant professional qualification.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $145,860.00

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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 11/09/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

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More about this job

Skills

Decision making
Vendor management
Onboarding
Performance management
Reporting
Documentation
Financial analysis
SQL
Python
Data analysis
Business intelligence
Tableau
Microsoft Power BI
Problem solving
Collaboration
Stakeholder management
Forecasting
Procurement
AWS
Google Cloud
Databricks

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