Head of Risk Adjustment/Coding Operations

Who You Are You are an experienced Risk Adjustment leader with a demonstrated ability to design, scale and evolve Medicare Advantage risk adjustment programs in complex, multi-market environments. You bring an enterprise mindset 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 excellence — it requires thoughtful prioritization, scalable design and a clear connection between effort, impact and outcomes. 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 provide personalized, local care for seniors in towns across America. We believe that patients’ needs come first, and that primary care is the foundation of patient centric healthcare. With Oasis, patients receive better access 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 journey. 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 all 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 lead a team of coding professionals and work closely with Central Operations, Quality, Data, Clinical and Market leaders to ensure risk adjustment activities are integrated with enterprise 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 aligned with provider partnerships. Key Responsibilities: Define and execute the enterprise risk adjustment strategy in partnership with cross-functional leaders, ensuring alignment with organizational objectives, payer requirements, and regulatory standards. Design and oversee risk adjustment programs that balance retrospective and prospective approaches, informed by performance data, operational feasibility, and provider experience Lead 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 outcomes and value, and inform ongoing prioritization Partner with Clinical and Market leaders to support effective, right-sized provider education and engagement related to documentation and coding Collaborate with Data and Technology teams to leverage analytics, automation, and tools that improve efficiency and decision-making across the risk adjustment lifecycle Develop and mentor the risk coding team, fostering accountability and continuous 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 Develop and maximize our Coding Education Platform to provide a tiered to solution for our provider partners Partner with all 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 Our Team We invest in the personal and professional success of our team. We take care of our people and offer robust benefits including 401K, medical, dental, vision and generous time off plans. We are committed to supporting your growth with a development program that starts with onboarding 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 healthcare administration, public health, business administration, or related 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 outcomes 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 continuous improvement (Start-Up experience a plus). Salary Range $200,000 — $250,000 USD The posted salary range reflects the broader pay range for the level associated with this role. Because the range is designed to support growth over time, starting salaries are typically aligned 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 current or future visa sponsorship. This role is open to applicants currently residing in the United States. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status, or disability status.