Remote Manager, Risk Adjustment — Provider Partnerships

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

Benefits offered by this job

Unlimited vacation

Performance bonuses

Sales commissions

Comprehensive benefits

Job summary

Oscar Health is hiring a Manager, Risk Adjustment, Provider Partnerships to lead cross-functional RA initiatives and provider engagement. The role guides strategy, performance, and contract enablement across Risk Adjustment, Network, Market, Data Science, and external partners.

You will report to the Director, Risk Adjustment Prospective and Planning. This is a remote role open to most US states with some geographic restrictions.

Qualifications

• 4+ years of program management, strategic planning, provider partnerships, health-plan operations, risk adjustment, contracting, or related field.

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 into provider agreements and operating models.
• Establish and maintain operational relationships with provider organizations; drive alignment on performance expectations and commitments.
• Analyze provider performance, workflows, and documentation/coding trends to identify causes, prioritize opportunities, and develop targeted mitigation plans.
• Lead cross-functional implementation of provider-specific interventions; manage dependencies and elevate risks that threaten outcomes.
• Develop and communicate performance reporting, program insights, risks, and recommendations to 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.

Skills

Program management

Strategic planning

Provider partnerships

Health-plan operations

Risk adjustment

Contracting

Data analysis

Stakeholder management

Job description

Oscar Health is hiring a Manager, Risk Adjustment, Provider Partnerships to lead cross-functional RA initiatives and provider engagement. The role guides strategy, performance, and contract enablement across Risk Adjustment, Network, Market, Data Science, and external partners.

You will report to the Director, Risk Adjustment Prospective and Planning. This is a remote role open to most US states with some geographic restrictions.