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Salary: USD 96,131 - 140,191 / annual
Oscar Health is seeking a Manager, Risk Adjustment, Provider Partnerships to lead strategy and execution of provider-facing risk adjustment initiatives within the Strategic Planning team. This role owns cross-functional program delivery across Risk Adjustment, Network, Market, Data Science, and external provider partners. You will establish provider engagement and performance-management approaches, translate performance data into targeted improvement strategies, and represent Risk Adjustment priorities in contract, implementation, and operational planning discussions.
Key responsibilities include leading end-to-end strategy, implementation, and ongoing management of the Risk Adjustment Provider Partnerships program with defined milestones, operating rhythms, risks, and success metrics. You will partner with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science teams to incorporate risk-adjustment requirements into provider agreements and operating models. You'll establish and maintain operational relationships with provider organizations, drive alignment on performance expectations, and analyze provider performance, workflows, and documentation/coding trends to identify improvement opportunities.
Additional responsibilities include leading cross-functional implementation of provider-specific interventions, managing dependencies and escalating risks, developing and communicating performance reporting and program insights to internal leaders and external partners, and building scalable provider education and engagement approaches. You will report to the Director, Risk Adjustment Prospective and Planning.
The position is fully remote and open to US candidates, excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and US Territories. Occasional travel is required for team meetings and company events.
**Requirements:**
- 4+ years of relevant experience in program management, strategic planning, provider partnerships, health-plan operations, risk adjustment, contracting, or a 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 stakeholder audiences
- Strong stakeholder-management, communication, and problem-solving skills, including experience navigating external partner relationships
**Bonus qualifications:**
- Risk adjustment experience in a health plan, provider organization, health system, or consulting environment
- Experience with provider contracting, value-based care, provider performance programs, or provider engagement models
- SQL/BigQuery or comparable analytical-tool experience
- Lean/Six Sigma or similar process improvement experience
