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Salary: USD 165,951 - 248,926 / annual
The Director, Risk Adjustment Product & Technology will lead the product roadmap and technology capabilities for Mosaic Health's enterprise Burden of Illness (BOI) Hub—a centralized intelligence and orchestration platform that integrates clinical, claims, payer, attribution, and supplemental data to identify, prioritize, and capture risk adjustment opportunities across patient populations.
In this role, you will own the evolution of the BOI Hub, moving the organization from fragmented, vendor-specific, and manually driven prioritization toward an enterprise-owned approach to risk adjustment decisioning and orchestration. You will define how opportunities are identified, deduplicated, economically prioritized, routed to appropriate execution engines, and measured through completion.
Key responsibilities include:
**Strategic Leadership & Product Vision**
Own the product vision, strategy, roadmap, and operating model for Mosaic's enterprise risk adjustment technology capabilities. Translate Risk Adjustment, Clinical, Operations, market, payer, and financial requirements into scalable product and technology solutions. Define target-state architecture and multi-year roadmap for moving from fragmented tools to a standardized enterprise platform. Establish clear distinctions between enterprise-owned decisioning, foundational data capabilities, execution engines, vendor functionality, and operational workflows.
**Burden of Illness Hub Development**
Build the Hub as the enterprise system for patient eligibility and prioritization, population identification, opportunity aggregation and deduplication, clinical and economic prioritization, work queue generation, intervention routing, opportunity status tracking, and enterprise performance analytics. Establish common rules and governance for opportunity surfacing, suppression, combination, escalation, and routing. Ensure prioritization logic is transparent, measurable, and configurable by population, payer, market, and intervention type. Create feedback loops where outcomes continuously improve future prioritization.
**Cross-Functional Collaboration**
Partner closely with Risk Adjustment, Clinical, Coding, Operations, Product, Engineering, Data & Analytics, Finance, and market leadership. Serve as a senior product and technology partner to external vendors, ensuring platforms like Navina operate as execution engines within Mosaic's broader enterprise strategy. Lead and mentor multidisciplinary teams including workflow analysts, clinical informatics resources, optimization specialists, and program managers.
**Change Management & Adoption**
Ensure multiple execution channels (point-of-care clinical technology, coding platforms, AI/clinical rules, prospective/retrospective interventions, provider workflows, attribution interventions, and operational outreach) operate against a common enterprise prioritization strategy. Define when and how opportunities move between execution channels and establish clear ownership, handoffs, and disposition logic.
**Technology Evaluation & Performance**
Evaluate emerging technologies—including AI, NLP, clinical inference, and automation—for their ability to improve identification and capture of clinically appropriate opportunities. Define and monitor operational and clinical metrics tied to workflow optimization. Use data and analytics to identify inefficiencies, quantify impact, and guide prioritization decisions. Develop executive-level reporting demonstrating ROI, adoption, productivity, and quality outcomes.
**Requirements**
Minimum qualifications:
- Bachelor's degree in healthcare administration, nursing, informatics, business, information systems, or related field (advanced degree preferred)
- 10+ years of progressive leadership experience in healthcare operations, clinical informatics, healthcare technology, or workflow optimization, with at least 5 years in a senior leadership role
- Demonstrated experience leading enterprise clinical transformation or EHR optimization initiatives at scale
- Proven success driving cross-functional operational and technology initiatives in complex healthcare environments
- Strong understanding of ambulatory and/or population health clinical workflows
- Experience with change management, clinician stakeholder engagement, and adoption strategies
- Track record of translating technology capabilities into measurable clinical and operational outcomes
Preferred qualifications:
- Advanced degree (MHA, MBA, MS in Informatics, or equivalent)
- Certification or demonstrated proficiency in EHR workflow optimization
- Experience implementing ambient AI documentation tools or AI-enabled clinical decision support
- Background in process improvement methodologies (Lean, Six Sigma, or equivalent)
- Experience in a multi-entity or integrated healthcare delivery system spanning primary care, specialty, and value-based care models
Technical fluency:
- Working knowledge of EHR platforms and clinical workflow configuration, particularly Athena
- Familiarity with AI-enabled clinical tools, telehealth platforms, and digital health technologies and their integration into clinical workflows
- Understanding of population health platforms and care management tools
- Ability to translate workflow and technology concepts clearly across clinical, operational, and technical audiences
Key competencies:
- Executive presence with ability to communicate clinical technology strategy to senior clinical, operational, and business audiences
- Strong instincts for driving adoption and behavior change across large, distributed clinical populations
- Cross-functional collaboration and stakeholder management
- Commitment to measurable outcomes, continuous improvement, and evidence-based decision-making
- Ability to lead through managers and analysts, setting direction and holding teams accountable to high standards
