Program Delivery Principal – Risk Adjustment Operations

RiskRiskFull TimeRemoteTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

17 days ago

Salary

$138.9K - $191K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Provide vision, leadership, and direction for multi-disciplinary program teams focused on risk adjustment operations workflow transformation. • Develop and execute program strategies that optimize medical record retrieval, coding accuracy, and data sharing across business and technology stakeholders. • Identify and implement innovative AI use cases to improve risk adjustment outcomes, including automation, predictive analytics, and process optimization. • Oversee program planning, execution, risk management, and delivery across multiple workstreams, ensuring alignment with organizational goals and compliance standards. • Cultivate strong relationships with internal partners, technology vendors, and executive leadership to drive consensus and successful program adoption. • Lead program governance, including the establishment and execution of frameworks, performance metrics, and reporting processes. • Drive continuous improvement initiatives, change management, and best practices across all facets of risk adjustment operations workflow. • Manage program budgets, resources, and timelines to achieve desired outcomes. • Prepare and deliver presentations and updates to senior and executive leadership. • Proactively monitor and evaluate emerging industry trends, regulatory changes, and technological advancements—particularly in risk adjustment, data management, and AI—ensuring program strategies remain innovative, competitive, and aligned with best practices and compliance requirements.

Job Requirements

  • Bachelor’s degree in information technology, business administration, healthcare, or related field.
  • 5+ years of experience delivering complex technology programs or projects, preferably within risk adjustment or healthcare operations.
  • Demonstrated experience with governance frameworks and executive-level reporting.
  • Proven ability to lead and influence matrixed, cross-functional teams in a highly regulated environment.
  • Strong understanding of risk adjustment processes, data management, and coding standards.
  • Experience in the design and delivery of technology solutions, including AI/ML applications in healthcare.
  • Excellent analytical, organizational, and communication skills.

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance

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