Risk Adjustment, Operations Manager

Devoted HealthWaltham, MA
1d$80,000 - $120,000

About The Position

A bit about this role: We’re seeking a highly diligent, process-oriented professional to join our team as an Evaluation Manager. This role is for someone who thrives in fast-moving environments, enjoys building and refining processes, and communicates with clarity. 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. This role reports to the Senior Manager, Risk Adjustment External Audit Program.

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 SQL to form independent insights, identify trends, and validate what’s working. Spreadsheets (e.g. Google Sheets) are a favorite tool in your toolkit
  • Curiosity and comfort experimenting with AI (including LLMs) or other emerging tools

Nice To Haves

  • Experience in healthcare operations, operations, or quality assurance

Responsibilities

  • Manage a multi-step medical document evaluation process with tight turnaround times, ensuring accuracy and consistency in responding to crucial external audit requests
  • Oversee and coordinate production work with offshore teams, maintaining clear expectations and quality standards
  • Identify opportunities for process improvement and implement changes that enhance scalability, transparency, and quality
  • Communicate updates, risks, and recommendations clearly to cross-functional stakeholders
  • Collaborate with risk adjustment coding experts to build a chart evaluation process that extracts the correct information in an efficient and meaningful manner
  • Support special projects that require structured thinking, thoroughness, and cross-team collaboration

Benefits

  • Employer sponsored health, dental and vision plan with low or no premium
  • Generous paid time off
  • $100 monthly mobile or internet stipend
  • Stock options for all employees
  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
  • Parental leave program
  • 401K program
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