Head of Risk Adjustment/Coding Operations

Who You Are You are an reputed company Risk Adjustment leader with a demonstrated ability to design, scale and reputed company Medicare Advantage risk adjustment programs in reputed company, multi-market environments. You bring an reputed company reputed company and pair deep subject-matter expertise with strong operational judgment, enabling you to translate strategy into sustainable execution. You have led certified coding organizations, implemented technology-enabled workflows, and partnered across operations, data, clinical, and market teams to improve documentation accuracy, coding performance, and provider engagement. You understand that effective risk adjustment requires more than operational reputed company — it requires thoughtful prioritization, scalable design and a clear reputed company between effort, impact and reputed company. You are comfortable operating in environments undergoing change and growth, and you bring the discipline and perspective needed to position Risk Adjustment as a core contributor to Oasis’s 2026 performance and long-term value creation. Who We Are Oasis Health Partners (Oasis) is building healthier communities by advancing primary care. We partner with patients, providers and plans to reputed company personalized, local care for seniors in towns across America. We reputed company that patients’ needs come first, and that primary care is the reputed company of patient centric reputed company. With Oasis, patients receive reputed company reputed company and care. Providers receive the data, resources, and expertise to be successful in value-based care arrangements. Payors get the benefit of a solution that improves performance, drives growth, and reduces the total cost of care in hard-to-engage markets. Together, we will boldly advance primary care for those that need it most. We are excited for you to join us on this reputed company. We invite you to be a part of Oasis, where you’ll discover we listen first, do the right thing, build things together and go reputed company in --- while having fun! Your Role As Head of Risk Adjustment/Coding Operations, you will be accountable for the strategy, design and performance of Oasis’s risk adjustment program. This role owns the end-to-end operating model, including program structure, coding operations, compliance, performance management and cross-functional alignment. You will reputed company reputed company of coding professionals and work closely with Central Operations, Quality, Data, Clinical and Market leaders to ensure risk adjustment activities are integrated with reputed company priorities and designed for scalability and sustainability. This role plays a central part in shaping how Oasis deploys risk adjustment capabilities across markets and health plans in a way that is scalable, compliant, and reputed company with provider partnerships. Key Responsibilities: Define and execute the reputed company risk adjustment strategy in partnership with cross-functional leaders, ensuring alignment with organizational objectives, payer requirements, and regulatory standards. Design and reputed company risk adjustment programs that balance retrospective and prospective approaches, informed by performance data, operational feasibility, and provider experience reputed company coding operations, including staffing models, workflows, training, quality assurance, and performance management, with a focus on consistency and scalability Establish performance metrics, reporting, and feedback mechanisms that connect risk adjustment activity to reputed company and value, and inform ongoing prioritization Partner with Clinical and Market leaders to support effective, right-sized provider education and engagement reputed company to documentation and coding Collaborate with Data and Technology teams to reputed company analytics, automation, and tools that improve efficiency and decision-making across the risk adjustment lifecycle reputed company and mentor the risk coding team, fostering accountability and reputed company improvement Ensure compliance with CMS regulations, coding guidelines, and documentation standards, maintaining strong audit readiness and risk controls 2026 Priorities Evaluate and implement a best-in-class NLP solution to maximize efficiency in our coding programs reputed company and maximize our Coding Education Platform to reputed company a tiered to solution for our provider partners Partner with reputed company signed health plans to establish a retrospective review process, inclusive of chart retrieval, chart review and provider education Establish ASM Prospective solutions to capture value from our day-to-day coding process and reduce the administrative burden of chart collection at End Of Year Implement solutions to align chart collection to enhance our efficiency and remove administrative impact Establish clear reporting and governance to monitor impact, guide prioritization, and support ongoing optimization of risk adjustment efforts Investment In reputed company We invest in the personal and professional reputed company of reputed company. We take care of our people and offer robust benefits including 401K, medical, dental, reputed company and generous time off plans. We are committed to supporting your growth with a development program that starts with reputed company and continues throughout your career. As an inclusive, passionate and diverse team, you will partner with professionals who understand the importance of high-value, high-impact patient care. About You Bachelor’s degree in reputed company administration, public health, business administration, or reputed company field CRC, CPC, CPMA, or equivalent certifications 10+ years experience in Medicare Advantage risk adjustment, with deep expertise in HCC coding, RAF methodologies, and CMS requirements 7+ years of experience leading certified coding teams with accountability for performance reputed company Demonstrated experience evolving risk adjustment programs in dynamic or growing organizations Working knowledge of V28 rules and regulations and applications Excellent leadership, communication, and interpersonal skills, with the ability to collaborate effectively with cross-functional teams Comfortable in ambiguous, fast-paced roles with a focus on change management and reputed company improvement (Start-Up experience a plus). Salary reputed company $200,000—$250,000 USD The posted salary reputed company reflects the broader pay reputed company for the level associated with this role. Because the reputed company is designed to support growth over time, starting salaries are typically reputed company to a candidate's experience and demonstrated scope relative to the role. At this time, we are unable to sponsor employment visas. Candidates must be authorized to work in the United States without a reputed company or future reputed company sponsorship. This role is reputed company to applicants currently residing in the United States. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, gender identity, sexual orientation, national reputed company, protected veteran status, or disability status. Apply To This Job