Manager, Risk Adjustment, Provider Partnerships

Oscar-Health-; United States; Remote; USD 96,000 - 140,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Unlimited vacation

Annual performance bonuses

Job summary

Oscar Health is seeking a Manager, Risk Adjustment (RA), Provider Partnerships to lead strategy and cross-functional delivery across RA, Network, Market, Data Science, and external partners. You will own engagement, performance management, and improvement of documentation and coding outcomes, reporting to the Director, Risk Adjustment Prospective and Planning.

The role is fully remote for US residents (excluding a few states) with travel for meetings/events.

Qualifications

• 4+ years of program management, provider partnerships, or risk adjustment-facing operations.
• Experience leading cross-functional programs from planning through implementation and ongoing performance management.
• Ability to use data to identify opportunities, actions, and communicate conclusions to diverse audiences.
• Strong stakeholder-management and external-partner relationship navigation skills.
• Risk adjustment experience in health plan, provider organization, or related environment.
• Experience with provider contracting, value-based care, or engagement models.

Responsibilities

• Lead end-to-end strategy and execution of the Risk Adjustment Provider Partnerships program with milestones and metrics.
• Collaborate with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science to embed requirements into provider agreements.
• Establish and maintain relationships with provider organizations and align on performance expectations.
• Analyze provider performance, workflows, and coding trends to identify opportunities and improvements.
• Oversee cross-functional implementation of interventions, manage dependencies, and escalate risks.
• Develop and communicate program insights, risks, and recommendations to leaders and partners.
• Build scalable provider education, engagement, and incentive approaches for risk-adjustment adoption.
• Ensure compliance with applicable laws and regulations.
• Perform additional duties as assigned.

Skills

Program management

Cross-functional leadership

Data analysis

Stakeholder management

Risk adjustment

Provider contracting

SQL/BigQuery

Lean Six Sigma

Tools

SQL/BigQuery

Job description

Remote

About the role:

The Manager, Risk Adjustment (RA), Provider Partnerships leads the strategy and execution of Oscar's provider-facing risk adjustment initiatives. You will own cross-functional program delivery across Risk Adjustment, Network, Market, Data Science, and external provider partners; establishes the provider engagement and performance-management approach; and translates performance data into targeted improvement strategies. You will represent Risk Adjustment priorities in contract, implementation, and operational planning discussions, manages risks and dependencies, and drives measurable improvement in documentation and coding outcomes.

You will report into the Director, Risk Adjustment Prospective and Planning.

Work Location:

This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $106,812 - $140,191 per year. The base pay for this role in all other locations is: $96,131 - $126,172 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, annual performance bonuses and sales commissions.

Responsibilities:

• Lead the end-to-end strategy, implementation, and ongoing management of the Risk Adjustment Provider Partnerships program, including program plans, milestones, operating rhythms, risks, and success metrics.
• Partner with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science teams to incorporate risk-adjustment requirements and enablement approaches into provider agreements and operating models.
• Establish and maintain operational relationships with provider organizations; drive alignment on performance expectations, improvement opportunities, and mutual commitments.
• Analyze provider performance, workflows, and documentation/coding trends to identify causes, prioritize opportunities, and develop targeted mitigation and improvement plans.
• Lead cross-functional implementation of provider-specific interventions; manage dependencies, resolve issues, and elevate decisions or risks that threaten outcomes or timelines.
• Develop and communicate performance reporting, program insights, risks, and recommendationsto internal leaders and external partners.
• Build scalable provider education, engagement, and incentive approaches that improve adoption of risk-adjustment best practices.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements:

• 4+ years of relevant experience in program management, strategic planning, provider partnerships, health-plan operations, risk adjustment, contracting, or a related field.
• Demonstrated experience leading complex, cross-functional programs from planning through implementation and ongoing performance management.
• Experience using quantitative and qualitative data to identify opportunities, recommend actions, and communicate conclusions to varied stakeholder audiences.
• Strong stakeholder-management, communication, and problem-solving skills, including experience navigating external partner relationships.
• Risk adjustment experience in a health plan, provider organization, health system, or consulting environment.
• Experience with provider contracting, value-based care, provider performance programs, or provider engagement models.
• SQL/BigQuery or comparable analytical-tool experience.
• Lean/Six Sigma, or similar process improvement experience.

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI)

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Reasonable Accommodation

Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([e-mail]) to make the need for an accommodation known.

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For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in Oscar Health's Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

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A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

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Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.