Risk Adjustment Program Manager (Healthcare)

TL;DR

Risk Adjustment Program Manager (Healthcare): Managing the day-to-day operations of the External Audit Program with an accent on operational excellence and cross-functional risk adjustment data audit responses. Focus on building AI-native monitoring for KPIs and leveraging LLMs to drive program efficiency.

Location: Must be located within the 50 U.S. states. Preference for residence in the Greater Boston Area. Standard working hours are in Eastern Timezone.

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

Company

An all-in-one healthcare company combining compassion, insurance, clinical care, and technology to improve the health and well-being of older Americans.

What you will do

• Manage daily operations of the External Audit Program to ensure alignment with regulatory timelines and goals.
• Support Retrieval, Evaluation, and Submission workstreams to address shifting priorities during the audit cycle.
• Partner with workstream leads to implement process improvements for enhanced scalability, transparency, and quality.
• Communicate updates, risks, and recommendations clearly to cross-functional stakeholders.
• Develop AI-native monitoring for program-wide KPIs to support leadership reporting.
• Execute special projects requiring structured thinking, thoroughness, and cross-team collaboration.

Requirements

• 4+ years of experience managing processes with tight turnaround times.
• Strong written and verbal communication skills.
• Ability to analyze data using database query tools and Google Sheets.
• Curiosity and comfort experimenting with LLMs and emerging AI technologies.
• Must be based in the United States (50 states).

Nice to have

• Experience in healthcare operations or quality assurance.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility.
• 401K program.