Manager, Risk Adjustment – Clinical Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and execute Daymark’s strategy for risk capture, ensuring alignment with its care model and payer agreements.

• Identify areas for enhancement in documentation, focusing on suspects and refreshables.

• Create and implement workflows that incorporate risk adjustment into the delivery of care.

• Collaborate with Care Teams to guarantee that workflows are functional, adopted, and effective.

• Work alongside Product and Data teams to integrate workflows into tools and ensure accurate, timely data management.

• Assess and manage vendors that assist with chart preparation, suspecting, and coding workflows.

• Establish performance tracking, reporting mechanisms, and review schedules.

• Recognize performance deficiencies and drive focused improvements.

• Enhance care delivery workflows, enrollment operations, and inter-team collaboration.

• Diagnose operational challenges and implement solutions to improve reliability and efficiency.

• Convert operational requirements into workflows, tools, and processes in collaboration with cross-functional teams.

• Assist in preparing operations for new markets and service offerings.

• Translate strategic objectives into actionable operational plans.

• Ensure accountability for KPIs and follow-through on commitments.

• Facilitate operational review cycles and enhance performance visibility.

• Identify gaps in execution and assist in driving resolutions.

• Engage in high-priority operational initiatives as they arise.

⛳️ Requirements

• Experience in risk adjustment, population health, or operations within value-based care.

• Strong knowledge of HCC coding, suspecting, and workflows for chart review.

• Proven experience collaborating with clinicians and integrating workflows into care delivery.

• Experience working in partnership with Product, Data, and Analytics teams.

• Experience in startup or rapidly growing environments is advantageous.

• Ability to simplify complex concepts into actionable workflows.

• Comfortable working across clinical, operational, and technical teams.

• Capacity to thrive in uncertain environments and build solutions from the ground up.

• Ability to work during Central or Eastern time business hours.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health and wellness benefits.

• Opportunities for professional development and growth.

• Flexible working arrangements to support work-life balance.