Remote Risk Adjustment Provider Partnerships Manager

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

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Unlimited vacation

401(k) plan

Job summary

Oscar Health is seeking a Manager, Risk Adjustment, Provider Partnerships to lead the RA program strategy and execution across cross-functional teams. The role requires strong collaboration with Network, Market, Legal, and Data Science to embed risk-adjustment needs into provider contracts and operating models.

You will drive improvement in documentation and coding outcomes, manage dependencies, and report on performance to internal leaders and partners.

Qualifications

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

Responsibilities

• Lead end-to-end strategy, implementation, and ongoing management of the RA Provider Partnerships program.
• Partner with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science to incorporate RA requirements into provider agreements.
• Establish and maintain operational relationships with provider organizations; drive alignment on performance expectations and commitments.
• Analyze provider performance, workflows, and coding trends to identify causes and opportunities for improvement.
• Lead cross-functional implementation of provider-specific interventions and manage dependencies and risks.
• Develop and communicate performance reporting, insights, risks, and recommendations to leadership and partners.
• Build scalable provider education, engagement, and incentive approaches for better adoption of RA practices.
• Ensure compliance with applicable laws and regulations.
• Perform other duties as assigned.

Skills

Program management

Strategic planning

Stakeholder management

Data-driven decisions

Cross-functional collaboration

Tools

SQL/BigQuery

Job description

Oscar Health is seeking a Manager, Risk Adjustment, Provider Partnerships to lead the RA program strategy and execution across cross-functional teams. The role requires strong collaboration with Network, Market, Legal, and Data Science to embed risk-adjustment needs into provider contracts and operating models.

You will drive improvement in documentation and coding outcomes, manage dependencies, and report on performance to internal leaders and partners.