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Anthem, Inc. Mgr Medicare Risk Adj & Coding in Los Angeles, California


SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? CareMore is a proud member of the Anthem family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.

Location: Remote Based but may occasionally need to report to a CareMore corporate office. Seeking candidates that reside in either Los Angeles County, CA or Orange County, CA.

The Mgr Medicare Risk Adj & Coding is responsible for managing a team of coding professionals in the identification, collection and assessment of claim/encounter information as it pertains to CMS guidelines. Responsible for risk adjustment operations, provider education, data analysis, audits and may oversee the DRG audit process.

How will you make an impact:

  • Oversee day to day operations.

  • Ensure compliance with mandated and corporate policies.

  • Hire, train, coach, counsel, and evaluate performance of direct reports.


Minimum Requirements:

  • Requires CPC, CPC-H, CCS, or CCS-P and minimum of 2 years of experience in risk adjustment/healthcare industry; or any combination of education and experience, which would provide an equivalent background.

  • Requires AAPC or AHIMA coding certification.

  • Local travel to a CareMore corporate office may be required.

Preferred Skills, Capabilities and Experiences:

  • CRC, CDEO, CDIP certifications highly preferred.

  • Expertise in Medicare Risk Adjustment Programs strongly preferred.

  • Excellent communication skills, ability to present metric information internally and to external matrix partners highly preferred.

  • BA/BS in Health Care or Business preferred.

  • RN, LPN, or foreign physician preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.

REQNUMBER: PS73647-LaHabra