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Manager, Risk Adjustment & Clinical Operations

Role overview

Qualifications

  • Experience in risk adjustment, population health, or value-based care operations
  • Strong understanding of HCC coding, suspecting, and chart review workflows
  • Experience working with clinicians and embedding workflows into care delivery
  • Experience partnering with Product, Data, and Analytics teams

Responsibilities

  • Build and Scale Daymark’s Risk Adjustment Operations
  • Define and operationalize our approach to risk capture, aligned with our care model and payer contracts
  • Identify opportunities for improving documentation (e.g., suspects and refreshables)
  • Design and implement workflows that integrate risk adjustment into care delivery

Key facts

Hard skills

Other skills

  • Communication
  • Problem Solving
  • Strategic Thinking

About the company

Daymark Health logo

Daymark Health

Hospitals & Health Care

Daymark Health is a cancer care company that partners with health plans to provide in-home and virtual supportive and wraparound care to patients with cancer in collaboration with their own oncologists. Our mission is to transform the cancer care experience by delivering personalized, world-class care when and where patients need it most. Our community-based team of nurses, nurse practitioners, social workers, and Health Partners works to address the clinical, mental health, and social needs, offering care navigation, 24/7 support, mental health assistance, symptom management, and social support – all delivered virtually and in the home.

Company details

IndustryHospitals & Health Care
Company size2 - 10

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Job description

Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. Daymark’s comprehensive, personalized cancer care platform empowers patients with dedicated care navigation, symptom-focused support, behavioral health care, and social resources. Combined with evidence-based health interventions and a hybrid in-person + virtual care model, Daymark is improving the overall cancer experience for patients, providers, and health plans – and setting a new standard in cancer care. 

Daymark’s groundbreaking approach is led by CEO Dr. Justin Bekelman, a pioneer in transforming cancer care, alongside some of the nation’s foremost leaders in oncology and value-based care. Daymark Health is backed by Maverick Ventures, Yosemite, Oncology Ventures, Healthier Capital, Blue Venture Fund, and Healthcare Foundry.

Be cautious of recruitment fraud, and always confirm that communications are coming from an official Daymark Health email.

ABOUT THE ROLE

We are seeking a highly capable operator to lead Risk Adjustment Operations at Daymark while also serving as a core member of the Clinical Operations team. This role sits at the intersection of Clinical Operations, Finance, Product, and Data, and is responsible for ensuring we accurately capture patient complexity in a way that reflects the true clinical needs of our population.

You will take the lead in building and scaling our risk adjustment approach, from identifying opportunities to embedding workflows into care delivery to driving measurable performance improvement. Beyond risk adjustment, this role is part of the broader Clinical Operations team and will flex into other high-priority operational initiatives, including market launches, care delivery workflows, and enrollment operations.

This role is ideal for someone who enjoys owning a critical domain while also working across a wide range of operational problems in a fast-moving, early-stage environment.

WHAT YOU'LL DO

Build and Scale Daymark’s Risk Adjustment Operations

  • Define and operationalize our approach to risk capture, aligned with our care model and payer contracts
  • Identify opportunities for improving documentation (e.g., suspects and refreshables)
  • Design and implement workflows that integrate risk adjustment into care delivery and partner with Care Teams to ensure those workflows are usable, adopted, and effective
  • Partner with Product and Data to ensure workflows are reflected in tools and supported by accurate, timely data
  • Evaluate and manage vendors supporting chart prep, suspecting, and coding workflows
  • Establish performance tracking, reporting, and review cadences and Identify gaps in performance to drive targeted improvements

Broader Clinical Operations Priorities and Execution.

  • Improve care delivery workflows, enrollment operations, and cross-team coordination
  • Diagnose operational friction and implement solutions that improve reliability and efficiency
  • Partner with cross-functional teams to translate operational needs into workflows, tools, and processes
  • Support operational readiness for new markets and service lines
  • Step into high-priority operational initiatives as they emerge

Operational Infrastructure & Scaling

  • Translate strategic priorities into operational workplans
  • Ensure KPIs have clear ownership and follow-through
  • Support operational review cadence and performance visibility
  • Identify execution gaps and help drive resolution

WHAT WE ARE LOOKING FOR

Experience

  • Experience in risk adjustment, population health, or value-based care operations
  • Strong understanding of HCC coding, suspecting, and chart review workflows
  • Experience working with clinicians and embedding workflows into care delivery
  • Experience partnering with Product, Data, and Analytics teams
  • Startup or high-growth experience is a plus

Qualities

  • You are both strategic and highly execution-oriented
  • You can translate complex concepts into practical workflows
  • You are comfortable working across clinical, operational, and technical teams
  • You thrive in ambiguity and enjoy building from scratch
  • You are excited to own a domain while also contributing more broadly across the business

Additional Information

The expected compensation for this role is $120,000 to $150,000 annually, depending on location & experience.

This role is based in XX but will operate on either Central or Eastern time business hours.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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