Manager, Risk Mitigation (REMOTE)
Emergent Holdings

Southfield, Michigan

Posted in IT

This job has expired.

Job Info


The Manager, Risk Mitigation is responsible to plan, organize, direct, control, and lead the assigned business unit. This position specializes in development, planning, and leadership, and operates within broad objectives to ensure optimum utilization of capital, manpower, and equipment for the assigned business unit. The Manager, Risk Mitigation is responsible for oversight, strategy and execution of CMS audits for both Medicare Advantage and Commercial business.


  • Provides vision, strategy, leadership, planning, project coordination, and oversight for the execution of CMS mandated RADV Audits for Medicare Advantage and Commercial business.
  • Manages activities for provider and facility reimbursement for medical record retrieval.
  • Responsible for balancing workload to optimize the effectiveness of the department.
  • Manages activities of a department including, but not limited to, planning, problem solving, staff development, and communication.
  • Executes function/area objectives that support continuous improvement.
  • Provides effective and efficient solutions to complex business problems.
  • Provides high level oversight and leadership.
  • Manages professional, exempt, and non-exempt non-bargaining and bargaining unit employees.
  • Responsible for special projects and/or problem resolutions.

Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.



Bachelor's degree in a related field. Master's degree in a related field preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Coding Certification or progress toward certification is highly preferred and encouraged.


Seven (7) years of progressively more responsible experience in a health care environment with demonstrated technical experience that provides the necessary knowledge, skills, and abilities. Knowledge of CMS Regulations as demonstrated by prior work experience. Three (3) years management or supervisory experience with direct reports in health care required. Experience in health care industry with payers, third party administrators, benefit consultants, or health care IT required.

  • Ability to manage competing priorities and understand the downstream implications of shifting priorities.
  • Demonstrated expertise in health payer market and deep knowledge of payer operations.
  • Experience delivering product and/or projects to large-scale enterprises.
  • Expertise in defining and prioritizing business requirements and validating product capabilities.
  • Excellent organizational, communication, and presentation skills.
  • Ability to facilitate the completion of work in a matrix environment.
  • Word, Excel, PowerPoint experience required. MS Project preferred. JIRA is a plus.
  • Able to drive cross-functional coordination and alignment around initiatives to create competitive advantage in the marketplace.
  • Ability to work effectively with senior leaders and functional teams to ensure success.
  • Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
  • Ability to work with and empower others on a collaborative basis to ensure success of unit team.
  • Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
  • Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
  • Ability to establish workflows, manage multiple projects, and meet necessary deadlines.

Work is performed in an office setting with no unusual hazards. Travel may be required.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.

This job has expired.

More IT jobs

T and T Consulting Services
Falls Church, Virginia
Posted 10 minutes ago

T and T Consulting Services
Bethesda, Maryland
Posted 10 minutes ago

T and T Consulting Services
Washington, District of Columbia
Posted 10 minutes ago


$5 e-gift card
Upload your resume and receive $5 to Dunkin’ on us!
*Available to the first 200 NEW users

Powered by Broadbean logo

*By registering with our site, you agree to our
Terms and Privacy Policy.