Senior Manager, Risk Adjustment & Clinical Operations

Daymark Health; San Francisco (CA); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Daymark Health is seeking a leader to build and scale Risk Adjustment Operations, defining risk capture aligned with our care model and payer contracts to improve documentation and coding workflows. This role will drive process design and partner with care teams to deliver effective solutions.

You will collaborate with Product, Data, and Care Teams to embed workflows, manage vendor partnerships, and establish performance metrics across new markets.

Qualifications

• Experience in risk adjustment, population health, or value-based care operations.
• Strong understanding of HCC coding, suspecting, and chart review workflows.
• Experience working with clinicians and embedding workflows into care delivery.
• Experience partnering with Product, Data, and Analytics teams.
• Startup or high-growth experience is a plus.

Responsibilities

• Define and operationalize risk capture aligned with care model and payer contracts.
• Identify opportunities for improving documentation (suspects and refreshables).
• Design workflows that integrate risk adjustment into care delivery and partner with care teams to ensure those workflows are usable, adopted, and effective.
• Partner with Product and Data to ensure workflows are reflected in tools and supported by accurate, timely data.
• Evaluate and manage vendors supporting chart prep, suspecting, and coding workflows.
• Establish performance tracking, reporting cadences and identify gaps in performance to drive targeted improvements.

Skills

Risk adjustment

HCC coding

Population health

Workflow design

Cross-functional collaboration

Job description

Daymark Health is seeking a leader to build and scale Risk Adjustment Operations, defining risk capture aligned with our care model and payer contracts to improve documentation and coding workflows. This role will drive process design and partner with care teams to deliver effective solutions.

You will collaborate with Product, Data, and Care Teams to embed workflows, manage vendor partnerships, and establish performance metrics across new markets.