Lead Director Revenue/Quality Management

Fully accountable for MRA strategy, performance and results with the local Medicare market.
This is an individual contributor role at a senior manager level.
Engages with clinical teams and providers and serves as a SME on Medicare Risk Adjustment, coding, and documentation.
Ensures successful results in medical record retrieval projects, prospective coding programs, provider education initiatives, and dissemination of coding standard methodologies.
Investigates operational issues that impact MRA performance and works with business partners to implement solutions.
Inspires change to improve results and organizational efficiency related to MRA.
Pay Range
The typical pay range for this role is:
Minimum: 100,000
Maximum: 227,000
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
Healthcare and/or Managed Care experience
Demonstrated leadership with project management, financial analysis, strategic business planning, and risk management.
Experience with enterprise-wide and or cross-functional large-scale initiatives involving a wide degree of complexity.
Experience with value based risk and risk adjustment in a provider/clinical setting.
Strong analytical skills, with the ability to review and manipulate data to draw conclusions.
Proven relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization, as well as with providers and external vendors.
Preferred Qualifications
Proven experience successfully executing change in matrixed organizations.
Communication and presentation skills; experience addressing Senior Leadership.
Government business knowledge.
Education
Bachelors Degree or equivalent experience
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.