Remote Risk Adjustment Provider Partnerships Lead

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

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.