Prospective Risk Adjustment Analyst — Hybrid

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

Job summary

Oscar Health, Inc. is seeking an Analyst, Risk Adjustment to join the Risk Adjustment team in a hybrid New York, NY office. The role focuses on Prospective Risk Adjustment program operations, data reporting, and vendor coordination to ensure accurate reviews and timely issue resolution.

You will support Point-of-Care tools, VHA/IHA programs, and provider reporting while partnering with internal teams and external vendors. This position reports to the Sr.

Qualifications

• Strong analytical and problem-solving skills.
• Strong attention to detail and organizational skills.
• Ability to work effectively with data, reporting tools, spreadsheets, and operational workflows.
• Strong written and verbal communication skills with cross-team collaboration.
• Knowledge of healthcare operations, Risk Adjustment, or health plan processes.
• Experience translating data findings into actionable steps.
• Proficiency with Excel or Google Sheets; familiarity with SQL, Tableau, Looker.
• Experience in health plan/provider/healthcare tech environments.
• Exposure to prospective Risk Adjustment programs and related workflows.

Responsibilities

• Prospective Risk Adjustment Program Operations (30%)—Support daily operations across prospective Risk Adjustment programs and monitor workflows.
• Vendor Operations & Support (25%)—Assist external vendors with data exchanges and issue resolution.
• Reporting, Data Analysis & Reconciliation (20%)—Develop recurring reports and validate data across sources.
• Point-of-Care & Provider Programs (15%)—Support tools and provider reporting initiatives.
• Member & Claims Operations (10%)—Review exclusions and reconcile claims for programs.

Skills

Analytical skills

Attention to detail

Communication

Excel

Google Sheets

SQL

Tableau

Looker

Healthcare knowledge

Vendor coordination

Education

Bachelor's degree

Tools

Excel

Tableau

Looker

SQL

Job description

Oscar Health, Inc. is seeking an Analyst, Risk Adjustment to join the Risk Adjustment team in a hybrid New York, NY office. The role focuses on Prospective Risk Adjustment program operations, data reporting, and vendor coordination to ensure accurate reviews and timely issue resolution.

You will support Point-of-Care tools, VHA/IHA programs, and provider reporting while partnering with internal teams and external vendors. This position reports to the Sr.