Risk Adjustment Program Manager

About the role

A bit about this role: We’re seeking a highly diligent, process-oriented professional to join our team as a Program Manager. This role is for someone who thrives in fast-moving environments, enjoys building and refining processes, and communicates with clarity. This individual will work across multiple program workstreams at the direction of the Associate Director of the External Audit program. You’ll play a key part in ensuring operational excellence, supporting cross-functional risk adjustment data audit responses, and applying new tools - including large language models - to drive efficiency and quality.

Responsibilities and Impact

• Support the Associate Director in managing the day-to-day operations of the External Audit Program, ensuring all workstreams are aligned with program goals and regulatory timelines.
• Serve as a versatile operational resource, pivoting across workstreams (Retrieval, Evaluation, Submission) to address shifting priorities and volume during the audit cycle.
• Partner closely with workstream leads to identify opportunities for process improvement and implement changes that enhance scalability, transparency, and quality.
• Communicate updates, risks, and recommendations clearly to cross-functional stakeholders.
• Support the Associate Director in building out AI-native monitoring of program-wide KPIs that support regular operational updates and reporting to leadership.
• Support special projects that require structured thinking, thoroughness, and cross-team collaboration.

Requirements

• 4+ years experience managing processes with tight turnaround times.
• You have a high attention to detail and a reputation for following through.
• Strong communication skills, both written and verbal. You convey information clearly, proactively, and without ambiguity.
• Ability to pull and analyze data using database query tools and appetite to use emerging AI technology to form independent insights and identify trends. Spreadsheets (e.g. Google Sheets) are a favorite tool in your toolkit.
• Curiosity and comfort experimenting with AI (including LLMs) or other emerging tools.

Qualifications

• Experience in healthcare operations, operations, or quality assurance.

Skills

• Experience with emerging AI technology, including large language models.

Benefits

The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Pay

Salary range: $73,000 - $125,000 / year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package.

Schedule

Standard working hours are in Eastern Timezone. Semi-annual travel may be required to a Devoted office for on-site work.