Manager, Risk Adjustment & Clinical Operations

Daymark Health; San Francisco (CA); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Daymark Health is seeking a leader to build and scale Risk Adjustment Operations, defining risk capture aligned with our care model and payer contracts to improve documentation and coding workflows. This role will drive process design and partner with care teams to deliver effective solutions.

You will collaborate with Product, Data, and Care Teams to embed workflows, manage vendor partnerships, and establish performance metrics across new markets.

Qualifications

• Experience in risk adjustment, population health, or value-based care operations.
• Strong understanding of HCC coding, suspecting, and chart review workflows.
• Experience working with clinicians and embedding workflows into care delivery.
• Experience partnering with Product, Data, and Analytics teams.
• Startup or high-growth experience is a plus.

Responsibilities

• Define and operationalize risk capture aligned with care model and payer contracts.
• Identify opportunities for improving documentation (suspects and refreshables).
• Design workflows that integrate risk adjustment into care delivery and partner with care teams to ensure those workflows are usable, adopted, and effective.
• Partner with Product and Data to ensure workflows are reflected in tools and supported by accurate, timely data.
• Evaluate and manage vendors supporting chart prep, suspecting, and coding workflows.
• Establish performance tracking, reporting cadences and identify gaps in performance to drive targeted improvements.

Skills

Risk adjustment

HCC coding

Population health

Workflow design

Cross-functional collaboration

Job description

ABOUT THE ROLE

Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. Daymark’s comprehensive, personalized cancer care platform empowers patients with dedicated care navigation, symptom-focused support, behavioral health care, and social resources. Combined with evidence-based health interventions and a hybrid in-person + virtual care model, Daymark is improving the overall cancer experience for patients, providers, and health plans – and setting a new standard in cancer care.

Daymark’s groundbreaking approach is led by CEO Dr. Justin Bekelman, a pioneer in transforming cancer care, alongside some of the nation’s foremost leaders in oncology and value-based care. Daymark Health is backed by Maverick Ventures, Yosemite, Oncology Ventures, Healthier Capital, Blue Venture Fund, and Healthcare Foundry.

Be cautious of recruitment fraud, and always confirm that communications are coming from an official Daymark Health email.

WHAT YOU'LL DO

Build and Scale Daymark’s Risk Adjustment Operations

• Define and operationalize our approach to risk capture, aligned with our care model and payer contracts
• Identify opportunities for improving documentation (e.g., suspects and refreshables)
• Design and implement workflows that integrate risk adjustment into care delivery and partner with Care Teams to ensure those workflows are usable, adopted, and effective
• Partner with Product and Data to ensure workflows are reflected in tools and supported by accurate, timely data
• Evaluate and manage vendors supporting chart prep, suspecting, and coding workflows
• Establish performance tracking, reporting, and review cadences and Identify gaps in performance to drive targeted improvements

Broader Clinical Operations Priorities and Execution.

• Improve care delivery workflows, enrollment operations, and cross-team coordination
• Diagnose operational friction and implement solutions that improve reliability and efficiency
• Partner with cross-functional teams to translate operational needs into workflows, tools, and processes
• Support operational readiness for new markets and service lines
• Step into high-priority operational initiatives as they emerge

Operational Infrastructure & Scaling

• Translate strategic priorities into operational workplans
• Ensure KPIs have clear ownership and follow-through
• Support operational review cadence and performance visibility
• Identify execution gaps and help drive resolution

WHAT WE ARE LOOKING FOR

Experience

• Experience in risk adjustment, population health, or value-based care operations
• Strong understanding of HCC coding, suspecting, and chart review workflows
• Experience working with clinicians and embedding workflows into care delivery
• Experience partnering with Product, Data, and Analytics teams
• Startup or high-growth experience is a plus

Qualities

• You are both strategic and highly execution-oriented
• You can translate complex concepts into practical workflows
• You are comfortable working across clinical, operational, and technical teams
• You thrive in ambiguity and enjoy building from scratch
• You are excited to own a domain while also contributing more broadly across the business

Additional Information

The expected compensation for this role is $120,000 to $150,000 annually, depending on location & experience.

This role is based in XX but will operate on either Central or Eastern time business hours.