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 ourselves accountable 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 Introduction and Overview:

In this role, you will lead and oversee external coding vendor operations to ensure contractual obligations, Service Level Agreements (SLAs), quality performance, and accurate ICD-10/HCC coding deliverables are consistently met. You will serve as the primary operational liaison between external vendor leadership and internal cross-functional teams—including Coding Leadership, Engineering, and Compliance—to drive volume planning, system administration, and regulatory compliance.

Roles & Responsibilities

Operational & SLA Management

• Lead routine operational meetings with vendor leadership to review performance gaps, process improvements, and strategic goals.
• Track daily, weekly, and monthly service levels, audit tiers, and overall performance metrics.
• Align staffing models with volume projections in collaboration with resource planning and vendor leadership.
• Maintain accurate rosters of active and inactive coding contractors, managing audit record queues to ensure representative sampling.

User Access & Technical Administration

• Manage user accounts in Workday, including adding new hires and terminating departing users.
• Administer roles, environment permissions, and feature access within the coding application.
• Issue and track activation and deactivation tickets for all coding contractors.
• Partner directly with members of the engineering team to troubleshoot and resolve technical access or permission issues.

Compliance, Audits & Quality Control

• Ensure vendor adherence to contractual obligations, corporate policies, and PHI/HIPAA security standards.
• Monitor CVS compliance and training audit communications, proactively following up with and chasing down vendors to ensure timely responses.
• Conduct targeted quality reviews of health risk evaluations to verify clinical accuracy and ICD-10/HCC alignment.
• Identify operational risks and implement governance frameworks to correct compliance or delivery gaps.

Basic Qualifications:

• Experience: Minimum of 5 years of hands-on ICD-10 coding experience paired with 5–7 years in vendor management or operational supervisory roles.
• Required Certifications: Certified Professional Vendor Manager (CPVM) or Project Management Professional (PMP).

Preferred Qualifications:

• Preferred Certifications: Active coding credential (CPC, COC, CCS, CCS-P, or CCA) and Certified Risk Coder (CRC).
• Domain Knowledge: In-depth knowledge of Risk Adjustment (HCC) protocols across Medicare, Medicaid, and ACA Exchange lines of business.
• Technical Proficiency: Demonstrated experience managing user permissions in Workday and enterprise application administration platforms.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $132,600.00

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.

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.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.