Job summary
Job post source
This job is directly from Emergent Holdings
Job overview
The Manager, Risk Mitigation at Emergent Holdings leads and oversees risk mitigation efforts, focusing on CMS audits for Medicare Advantage and Commercial business to optimize resource use and compliance.
Responsibilities and impact
The role involves planning, directing, and managing CMS RADV audits, overseeing medical record retrieval reimbursement, balancing departmental workload, staff development, problem solving, and managing both exempt and non-exempt employees.
Compensation and benefits
The salary range is estimated between $92,200 and $154,500, with compensation based on experience, skills, location, and market factors; no specific benefits details are provided.
Experience and skills
Requires a bachelor's degree (master's preferred) with seven years of healthcare experience including CMS regulations knowledge, three years of management experience, and skills in project delivery, communication, and leadership; CRC certification is highly preferred.
Career development
Continuous learning is encouraged as per the company's philosophy, supporting professional growth through ongoing education and skill development.
Work environment and culture
The work is office-based with no unusual hazards and may require travel; the company emphasizes compliance, leadership, and collaborative team engagement.
Company information
Emergent Holdings is a healthcare-focused company involved in Medicare risk adjustment and compliance, emphasizing strategic leadership and operational excellence in healthcare auditing.
Team overview
The manager supervises a team of exempt and non-exempt staff, responsible for workload management, staff training, and performance appraisal within the risk mitigation department.
Job location and travel
The position is office-based with potential travel requirements; specific geographic location is not stated.
Unique job features
The role uniquely combines leadership in CMS audit execution with strategic oversight of Medicare Advantage and Commercial business risk mitigation, requiring specialized knowledge in healthcare payer operations and regulatory compliance.
Company overview
Emergent Holdings is a diversified enterprise specializing in insurance, risk management, and technology solutions. The company generates revenue through its various subsidiaries, which offer health insurance, workers' compensation, and innovative digital solutions for risk management. Founded as a part of Blue Cross Blue Shield of Michigan, Emergent Holdings has a rich history of leveraging technology to improve healthcare outcomes and operational efficiency. Their commitment to innovation and customer-centric services positions them as a leader in the insurance and risk management sectors.
How to land this job
Tailor your resume to emphasize your experience with Medicare risk adjustment, CMS audits, and medical record auditing, highlighting any certifications such as CRC if you have them or are pursuing them.
Highlight leadership skills, especially managing teams and projects related to healthcare compliance, risk mitigation, and audit execution to align with the managerial responsibilities.
Apply through multiple platforms including Emergent Holdings' corporate careers page, LinkedIn, and relevant healthcare job boards to maximize your application exposure.
Connect with current employees in the Risk Mitigation or Compliance divisions at Emergent Holdings on LinkedIn; use ice breakers like commenting on recent company initiatives in Medicare risk adjustment or asking about the team’s approach to CMS audits.
Optimize your resume for ATS by incorporating keywords from the job description such as 'CMS audits,' 'Medicare Advantage,' 'risk adjustment coding,' 'RADV audits,' and 'healthcare compliance' to improve your chances of passing automated screening.
Utilize Jennie Johnson's Power Apply feature to automate tailored resume submissions, identify multiple application channels, and find LinkedIn contacts for networking, allowing you to focus more on preparing for interviews and refining your skills.
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