Manager, Risk Adjustment, Provider Partnerships

🕒 Setembro 25

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $96.131 - $126.172 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

💰 Gerente de Contas

🗣️🇺🇸🇬🇧 Inglês obrigatório

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Oscar Health

1001 - 5000 funcionários

Fundada em 2012

⚕️ Seguro de Saúde

🏥 Saúde

💰 $355.000.000 Post-IPO Debt - Oscar Health em 2025-09

Healthcare Insurance • Healthcare

Oscar é uma agência de recrutamento STEM de classe mundial que oferece soluções de talentos líderes do setor. A empresa opera em seis marcas, conectando talentos de ponta com empresas em vários setores, incluindo tecnologia, construção, ciências da vida e energia renovável. Com escritórios ao redor do mundo, Oscar é reconhecida como uma das cinco melhores empresas para se trabalhar e está comprometida em oferecer excelência em serviços de recrutamento.

Descrição

• Lead the end-to-end strategy, implementation, and ongoing management of the Risk Adjustment Provider Partnerships program, including program plans, milestones, operating rhythms, risks, and success metrics • Partner with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science teams to incorporate risk-adjustment requirements and enablement approaches into provider agreements and operating models • Establish and maintain operational relationships with provider organizations; drive alignment on performance expectations, improvement opportunities, and mutual commitments • Analyze provider performance, workflows, and documentation/coding trends to identify causes, prioritize opportunities, and develop targeted mitigation and improvement plans • Lead cross-functional implementation of provider-specific interventions; manage dependencies, resolve issues, and escalate decisions or risks that threaten outcomes or timelines • Develop and communicate performance reporting, program insights, risks, and recommendations to internal leaders and external partners • Build scalable provider education, engagement, and incentive approaches that improve adoption of risk-adjustment best practices • Ensure compliance with all applicable laws and regulations • Perform other duties as assigned • Report to the Director, Risk Adjustment Prospective and Planning

🎯 Requisitos

• 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 • Compliance with all applicable laws and regulations • SQL/BigQuery or comparable analytical-tool experience (bonus) • Risk adjustment experience in a health plan, provider organization, health system, or consulting environment (bonus) • Experience with provider contracting, value-based care, provider performance programs, or provider engagement models (bonus) • Lean/Six Sigma, or similar process improvement experience (bonus)

🏖️ Benefícios

• Employee benefits • Unlimited vacation program • Annual performance bonuses • Sales commissions • Medical benefits • Dental benefits • Vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life insurance • Disability insurance • Paid wellness time and reimbursements • Fully remote work from a home office • Occasional travel for team meetings and company events

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