Position Summary As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk ...
Position Summary As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk ...
Risk Analyst
Hartford, CT · On-site
$70K - $90K/yr
Overview: Enterprise Risk Management (ERM) operates as an independent second line of defense ... Minimum of 1 year of experience in insurance, asset management or financial analytics * Strong ...
Risk Analyst
Hartford, CT · On-site
$70K - $90K/yr
Overview: Enterprise Risk Management (ERM) operates as an independent second line of defense ... Minimum of 1 year of experience in insurance, asset management or financial analytics * Strong ...
Senior Manager, Enterprise Actuarial - Catastrophe Risk Management
Hartford, CT · On-site
$120K - $198K/yr
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Senior Manager, Enterprise Actuarial - Catastrophe Risk Management
Hartford, CT · On-site
$120K - $198K/yr
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Strong understanding of insurance products and industry. * Demonstrated ability in actuarial and ... risk control, claim, and financials. * Able to effectively utilize this business knowledge in ...
Director of Quality & Risk Management
Bloomfield, CT · On-site
$112.50 - $137.50/hr
Maintains organizational compliance with CARF accreditation standards, CMS requirements, state and local regulations, life safety standards, and insurer risk management expectations. * Leads ...
Director of Quality & Risk Management
Bloomfield, CT · On-site
$112.50 - $137.50/hr
Maintains organizational compliance with CARF accreditation standards, CMS requirements, state and local regulations, life safety standards, and insurer risk management expectations. * Leads ...
Director of Quality & Risk Management
Bloomfield, CT · On-site
$125K/yr
Maintains organizational compliance with CARF accreditation standards, CMS requirements, state and local regulations, life safety standards, and insurer risk management expectations. * Leads ...
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Director of Quality & Risk Management
Bloomfield, CT · On-site
$125K/yr
Maintains organizational compliance with CARF accreditation standards, CMS requirements, state and local regulations, life safety standards, and insurer risk management expectations. * Leads ...
RISK ANALYST
Canton, CT · On-site
Risk Analyst Enterprise Risk Management | Banking ----- This position does not offer remote access. It is an in-office position located in Canton, CT. Summary of the Role The Risk Analyst is a detail ...
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RISK ANALYST
Canton, CT · On-site
Risk Analyst Enterprise Risk Management | Banking ----- This position does not offer remote access. It is an in-office position located in Canton, CT. Summary of the Role The Risk Analyst is a detail ...
RISK ANALYST
Canton, CT · On-site
Risk Analyst Enterprise Risk Management | Banking ----- This position does not offer remote access. It is an in-office position located in Canton, CT. Summary of the Role The Risk Analyst is a detail ...
Quick apply
RISK ANALYST
Canton, CT · On-site
Risk Analyst Enterprise Risk Management | Banking ----- This position does not offer remote access. It is an in-office position located in Canton, CT. Summary of the Role The Risk Analyst is a detail ...
Associate Risk Analyst
Hartford, CT · On-site
$69K - $103K/yr
The Model Risk Management Team manages model risk across The Hartford by working with the ... the insurance industry is preferred. * Strong analytical and critical thinking skills with the ...
Associate Risk Analyst
Hartford, CT · On-site
$69K - $103K/yr
The Model Risk Management Team manages model risk across The Hartford by working with the ... the insurance industry is preferred. * Strong analytical and critical thinking skills with the ...
Associate Risk Analyst
Hartford, CT · On-site
$69K - $103K/yr
The Model Risk Management Team manages model risk across The Hartford by working with the ... the insurance industry is preferred. * Strong analytical and critical thinking skills with the ...
Associate Risk Analyst
Hartford, CT · On-site
$69K - $103K/yr
The Model Risk Management Team manages model risk across The Hartford by working with the ... the insurance industry is preferred. * Strong analytical and critical thinking skills with the ...
Sales Executive - Personal Lines
$60K - $200K/yr
Experience advising individuals, families, high-net-worth clients on personal insurance and risk management strategies. * Experience working within an insurance brokerage, personal lines agency ...
Sales Executive - Personal Lines
$60K - $200K/yr
Experience advising individuals, families, high-net-worth clients on personal insurance and risk management strategies. * Experience working within an insurance brokerage, personal lines agency ...
Sales Executive - Commercial Lines
$60K - $200K/yr
... their risk management outcomes, modernize their benefits programs, and help them achieve their long-term financial goals. Founded in 2011, World is one of the fastest-growing, Top 25 insurance ...
Sales Executive - Commercial Lines
$60K - $200K/yr
... their risk management outcomes, modernize their benefits programs, and help them achieve their long-term financial goals. Founded in 2011, World is one of the fastest-growing, Top 25 insurance ...
Senior Risk Analyst
Hartford, CT · On-site
$107K - $127K/yr
Overview: Enterprise Risk Management (ERM) operates as an independent second line of defense ... Minimum of 4 years of experience in insurance, asset management or financial analytics * An ASA ...
Senior Risk Analyst
Hartford, CT · On-site
$107K - $127K/yr
Overview: Enterprise Risk Management (ERM) operates as an independent second line of defense ... Minimum of 4 years of experience in insurance, asset management or financial analytics * An ASA ...
Director of Safety & Risk
Hartford, CT · On-site
$90 - $120/hr
... managing relationships with insurance carriers, brokers, legal counsel and third-party ... Techniques of risk management and risk prevention. * Techniques for providing a high level of ...
Director of Safety & Risk
Hartford, CT · On-site
$90 - $120/hr
... managing relationships with insurance carriers, brokers, legal counsel and third-party ... Techniques of risk management and risk prevention. * Techniques for providing a high level of ...
R&I Managed Services Deals Desk Senior Manager
$91K - $321K/yr
Accounting, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Finance, Risk Management/Insurance - Demonstrating advanced skills in Enterprise Risk Management ...
R&I Managed Services Deals Desk Senior Manager
$91K - $321K/yr
Accounting, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Finance, Risk Management/Insurance - Demonstrating advanced skills in Enterprise Risk Management ...
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Quick apply
Build and manage a pipeline of large commercial prospects through proactive outreach, networking, and market engagement to achieve sales goals. * Develop tailored risk strategies and insurance ...
Accounting, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Finance, Risk Management/Insurance - Demonstrating advanced skills in Enterprise Risk Management ...
Accounting, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Finance, Risk Management/Insurance - Demonstrating advanced skills in Enterprise Risk Management ...
Insurance Risk Manager information
See Berlin, CT salary details
$81.8K - $91.1K
9% of jobs
$99.5K is the 25th percentile. Wages below this are outliers.
$91.1K - $100.4K
18% of jobs
$100.4K - $109.8K
12% of jobs
The median wage is $115.2K / yr.
$109.8K - $119.1K
19% of jobs
$119.1K - $128.4K
5% of jobs
$132.2K is the 75th percentile. Wages above this are outliers.
$128.4K - $137.7K
30% of jobs
$137.7K - $147.1K
7% of jobs
$147.1K - $156.4K
0% of jobs
$156.4K - $165.7K
0% of jobs
$165.7K - $175K
0% of jobs
$175K - $184.4K
0% of jobs
$81.8K
$120.4K
$184.4K
How much do insurance risk manager jobs pay per year?
What are the key skills and qualifications needed to thrive as an Insurance Risk Manager?
What is the difference between Insurance Risk Manager vs Insurance Underwriter?
| Aspect | Insurance Risk Manager | Insurance Underwriter |
|---|---|---|
| Credentials | Typically requires a bachelor's degree in risk management, finance, or related fields; professional certifications like ARM or CPCU are common | Usually holds a bachelor's degree in finance, economics, or related areas; certifications like CPCU or ARe are beneficial |
| Work Environment | Works in corporate risk management departments, analyzing and mitigating risks for the company | Works in insurance companies, assessing individual or business applications to determine coverage and premiums |
| Employer & Industry Usage | Used by insurance companies and large corporations to manage risk exposure | Primarily employed by insurance carriers to evaluate and approve insurance policies |
While both roles involve understanding insurance policies, the Insurance Risk Manager focuses on overall risk mitigation strategies within an organization, whereas the Insurance Underwriter evaluates individual insurance applications to determine coverage and pricing.
What does an Insurance Risk Manager do?
What are the most common challenges Insurance Risk Managers face when working across different departments?

$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 20 days ago
CVS Health rating
5.8
Based on 4,332 frontline employees who took The Breakroom Quiz
89th of 112 rated pharmacies
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 ourselvesaccountable 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.
Position Summary
As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.
The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.
Key Responsibilities
Lead the Medicare Advantage Risk Adjustment compliance program.
Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.
Assess operational processes for compliance risks related to risk adjustment activities.
Develop and implement corrective action plans for identified compliance issues.
Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.
Required Qualifications
Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance
Minimum 5 years in a leadership role
One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Health Information Management (RHIA/RHIT)
Nursing - Strong understanding of clinical documentation and medical record review
Certified Risk Adjustment Coder (CRC) with compliance experience
Provider coding audit/compliance leadership experience
Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits
Education
Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
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. This position also includes an award target in the company's equity award program.
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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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About CVS Health
Sourced by ZipRecruiter
Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US