Hybrid Risk Adjustment Analyst

Oscar Health, Inc.; New York (NY); Hybrid; USD 75,000 - 99,000; Full time

Job summary

Oscar Health, Inc. is hiring an Analyst, Risk Adjustment to join our Risk Adjustment team in New York. The role focuses on prospective Risk Adjustment programs and partnering with internal teams and external vendors to ensure accurate data, reporting, and operational workflows.

The Analyst will support Point-of-Care tools, VHA, IHA, and provider reporting, helping review member conditions, validate data, and resolve operational issues. This is a hybrid position with three days in-office per week.

Qualifications

• Strong analytical and problem-solving skills.
• Excellent attention to detail and organizational skills.
• Ability to work with data, reporting tools, spreadsheets, and operational workflows.
• Strong written and verbal communication across teams and external partners.

Responsibilities

• Prospective Risk Adjustment Program Operations (30%) – Support daily operations across prospective Risk Adjustment programs, including Point-of-Care tooling, VHA, IHA, and provider gap-reporting initiatives.
• Vendor Operations & Support (25%) – Support external vendors' day-to-day operational needs, coordinate deliverables and data exchanges, respond to questions, track issues, and partner to drive timely resolution.
• Reporting, Data Analysis & Reconciliation (20%) – Develop recurring reports and analyses; perform data validation and reconcile data across sources to identify discrepancies and opportunities.
• Point-of-Care & Provider Programs (15%) – Support programs providing health information to providers for review and clinical validation.
• Member & Claims Operations (10%) – Support member-level program operations, including exclusions from VHA and IHA programs; monitor and reconcile claims.

Skills

Analytical skills

Attention to detail

Data analysis

Communication

Education

Bachelor's degree

Tools

Excel

Google Sheets

SQL

Tableau

Looker

Job description

Oscar Health, Inc. is hiring an Analyst, Risk Adjustment to join our Risk Adjustment team in New York. The role focuses on prospective Risk Adjustment programs and partnering with internal teams and external vendors to ensure accurate data, reporting, and operational workflows.

The Analyst will support Point-of-Care tools, VHA, IHA, and provider reporting, helping review member conditions, validate data, and resolve operational issues. This is a hybrid position with three days in-office per week.