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Manager, Risk Adjustment MLTC-MAP

Centene · NY · Remote available · $87,700–$157,800 a year · Full time

Posted Oct 1, 2026 · We last checked this listing on Oct 6, 2026

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Likely interview questions for this role

Written from this job description, not a generic list. Each one notes what the interviewer is really checking.

About your past

Tell me about a risk adjustment strategy you shaped or managed. What moved the numbers?

What they are checking: Whether they have driven real results in risk adjustment rather than just reporting on them.

Walk me through a detailed workplan and issue log you built. How did you keep it current and useful?

What they are checking: Whether their project tools actually drove decisions or just sat in a shared folder.

Tell me about a time you had to explain a complicated regulatory or financial issue to people outside your field.

What they are checking: Whether they can make risk adjustment understandable to operations teams who must act on it.

What would you do

You need care management, claims and IT to change workflows for one product. None of them report to you. How do you get it done?

What they are checking: Whether they can lead across departments using workplans, data and relationships instead of authority.

Your dashboard shows a drop in risk scores for one plan this quarter. How do you figure out why?

What they are checking: Their approach to root cause when a number moves, separating data lag, population change and process failure.

How would you learn the local market dynamics of a plan you have not worked with before?

What they are checking: Whether they go find out how a specific market works before applying a one-size approach.

About the work

What do you know about New York MLTC and MAP plans, and how does risk adjustment work differently for them than for Medicare Advantage?

What they are checking: Whether they understand the specific long-term care products this role covers, which the posting strongly prefers.

How do assessment data, like the UAS-NY, connect to the revenue an MLTC plan receives, and where can it go wrong?

What they are checking: Whether they see how frontline assessment accuracy flows straight into plan revenue and compliance risk.

What would you put on a risk adjustment dashboard for senior management, and why those measures?

What they are checking: Whether they can pick the few metrics that show performance and risk without overwhelming leaders.

How do you keep risk adjustment work clean and compliant so that coding reflects what is truly documented?

What they are checking: Whether they respect the line between capturing accurate risk and overstating it, which carries real audit exposure.

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The full job description

As published by Centene.

Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J -1, OPT, or CPT. Experience working in managed care, Medicaid, Medicare, Marketplace, or long-term care environments preferred. New York MLTC experience strongly preferred. • Develop and implement action plans, across all departments affecting assigned products and plans, to address issues identified by the business units, including detailed workplans, issue logs, and progress reports • Identify and partner with various departments to implement assigned products business requirements • Develop and execute operational workflows specific to each product business requirements, competitive landscapes, and local market dynamics • Evaluate and manage the risk adjustment strategy across all functional areas that impact assigned products • Identify and support health plan initiatives related to assigned products • Prepare dashboards for senior management and identify improvement opportunities Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of project management, operations, quality improvement or data analysis/reporting experience in the healthcare industry. Previous managed care or Medicare experience preferred. Pay Range: $87,700.00 - $157,800.00 per year At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday. Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law , including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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