Director, Risk Adjustment Product – Technology

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $166k - $248.9k / year

⏰ Full Time

🔴 Lead

🎲 Risk

👻 Ghost score 0%

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Mosaic Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

👥 B2C

Healthcare • B2C

Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers covered by Commercial, Individual Exchange, Medicare, and Medicaid health plans. It brings together multiple operating units and brands (including CareMore Health, Millennium Physician Group/MPG, Castlight Health, Vera Whole Health, and apree health) to deliver coordinated primary care services and related care-management capabilities across payer types. Mosaic Health’s corporate site and leadership roster reflect a centralized platform structure with executive leadership overseeing business units and strategic partnerships.

📋 Description

• Own the product vision, strategy, roadmap, and operating model for Mosaic’s enterprise risk adjustment technology capabilities • Lead development and maturation of the Burden of Illness Hub as the central orchestration capability • Build the Hub for patient eligibility and prioritization, population identification, suspect and opportunity aggregation, deduplication, prioritization, work queue generation, intervention routing, status and disposition, attribution and retention interventions, and performance analytics • Establish common rules and governance for surfacing, suppressing, combining, escalating, or routing opportunities • Create feedback loops to improve future prioritization • Partner with Engineering, Data, Architecture, and Clinical Informatics to translate requirements into scalable technical solutions • Maintain a prioritized product backlog and roadmap • Ensure integrations with EHRs, clinical applications, analytics platforms, data infrastructure, and operational systems • Evaluate emerging technologies to improve identification, prioritization, and capture of clinically appropriate opportunities • Define execution-channel ownership, handoffs, and disposition logic across clinical technology, Navina, coding, AI, provider, attribution, and operational workflows • Collaborate with clinical, operational, analytics, finance, compliance, and technology teams • Lead and mentor multidisciplinary teams • Manage vendor relationships and support technology selection and evaluation • Support enterprise scaling, acquisitions, integrations, and operational transformation initiatives • Define and monitor operational and clinical metrics • Develop executive-level reporting demonstrating ROI, adoption, productivity, and quality outcomes • Drive continuous improvement across workflow and technology initiatives

🎯 Requirements

• Expertise in risk adjustment, healthcare product management, clinical technology, data, workflow design, and value-based care economics • Experience translating Risk Adjustment, Clinical, Operations, market, payer, and financial requirements into scalable product and technology capabilities • Experience defining target-state architecture and multi-year roadmaps • Experience with product requirements, user stories, workflows, acceptance criteria, and outcome measures • Experience partnering with Engineering, Data, Architecture, and Clinical Informatics • Experience with product governance, release planning, testing, adoption, and change-management processes • Experience integrating technology with EHRs, clinical applications, analytics platforms, data infrastructure, and operational systems • Knowledge of AI, NLP, clinical inference, and automation • Experience leading and mentoring multidisciplinary teams • Experience managing vendor relationships and participating in technology selection and evaluation • Experience using data and analytics to identify inefficiencies and guide prioritization decisions • Experience developing executive-level reporting on ROI, adoption, productivity, and quality outcomes