Manager, Risk Adjustment Operations

Position Overview:

• The Manager, Risk Adjustment Operations provides end-to-end operational management, delivery and support to new and existing MA and ACA Risk Adjustment Programs.
• Working closely with the Director, Risk Adjustment Programs, this position drives execution of operational priorities, manages program performance, and ensures timely delivery of strategic initiatives.
• The manager will be responsible for professional coaching and mentoring of program team members while fostering continuous process improvement.

Key Responsibilities:

• Drive day-to-day operational execution of Medicare Advantage and ACA Risk Adjustment initiatives, ensuring project milestones, regulatory deadlines, and operational deliverables are completed on schedule.
• Develop and maintain integrated project plans, operational calendars, risk logs, and status reporting to support successful program execution.
• Monitor program performance through dashboards, KPIs, and operational metrics; identify trends, escalate risks, and recommend data-driven improvements.

Qualifications:

• 5 years of Operations and/or Program management, with 3 years of Risk Adjustment Operations or Program Management.
• Experience leading complex, cross-functional operational initiatives involving multiple stakeholders and competing priorities.
• Strong analytical and problem-solving skills, including ability to interpret dashboards and operational reporting.

About Us:

• Capital Blue Cross offers a comprehensive benefits package including Medical, Dental & Vision, a Retirement Plan, and generous time off.
• We recognize that work is a part of life and foster a flexible environment where your health and wellbeing are prioritized.
• We value your professional and personal growth by investing heavily in training and continuing education.