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.
Under the direction of the Senior Manager of the RI Retro Ops Team, the Risk Adjustment Outreach Manager is responsible for leading initiatives that support the organization’s risk adjustment program and ensure timely and accurate data capture.
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
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $159,120.00This 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 05/02/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.