Health Plan Operations jobs

Director Risk Adjustment

WVU Medicine · Posted Nov 9, 2026

Open

Remote
Remote
Full-time · Manager
8+ years

Apply with Referso

Director Risk Adjustment

WVU Medicine · Posted Nov 9, 2026

Open

Remote
Remote
Full-time · Manager
8+ years

Apply with Referso

Director Risk Adjustment (Peak Health)

WVU Medicine · Posted Nov 9, 2026

Open

Remote, United States
Remote
Full-time · Director
8+ years

Apply with RefersoAI Apply on careers page

The Director of Risk Adjustment leads Peak Health's enterprise risk adjustment strategy and operations across all applicable lines of business.

Responsibilities

Develop and execute the enterprise risk adjustment strategy and governance framework across all applicable lines of business.
Monitor regulatory changes and emerging risk adjustment methodologies, translating them into operational strategies and process improvements.
Oversee programs supporting accurate diagnosis capture, medical record retrieval, chart review, coding, validation, and submission of risk adjustment data.
Establish and maintain coding standards, policies, procedures, and quality requirements across all applicable lines of business.
Oversee coding quality assurance, second-level reviews, audits, corrective action processes, coder productivity, key performance indicators, and compliance with applicable CMS, state, federal, and organizational requirements.

Requirements

Bachelor's degree in healthcare administration
business
health information management
nursing
public health

Skills

healthcare risk adjustment health plan operations

Technology Product Manager

SCAN Health Insurance · Posted Jul 16, 2026

Open

Long Beach, California, United States
Hybrid
Full-time
$92K–$159K per year
5+ years

Apply with RefersoAI Apply on careers page

Manages the development and lifecycle of technology products, including software, hardware, and services, overseeing multiple concurrent implementations and ensuring alignment with enterprise priorities.

Compensation

Base salary range: $92,400 to $159,133 annually

Responsibilities

Manages, plans and coordinates the development of new products, enhancements of existing products and technical solutions
Lead end to end project implementation for business needs
Understands business unit operations and identifies opportunities to leverage technology
Oversee multiple concurrent implementations, ensuring consistent delivery quality, governance, and alignment across workstreams
Partner with Product Owners to refine backlogs, prioritize features, and translate business needs into actionable IT requirements

Requirements

Bachelor’s Degree or equivalent work experience
Nice to have: Healthcare industry experience

Skills

Product Management Program Management Agile Delivery Backlog Management

Director, Client Management & Strategy, Behavioral Health

UnitedHealth Group · Posted Oct 10, 2026

Open

United States +2 more
Hybrid
Full-time · Director

Apply with RefersoAI Apply on careers page

Lead strategic client relationships and program design to drive Medicare membership growth and retention, ensuring operational excellence and financial performance.

Locations (3)

United States
Minneapolis, Minnesota, United States
Washington, D.C., District of Columbia, United States

Responsibilities

Develop strategic relationships across internal business units with a focus on growth and retention
Lead operational improvement and implementation processes
Collaborate with internal business unit partners to ideate, build and launch integrated programs and effectively priced solutions
Develop and execute strategic plans to drive business growth
Translate strategic business objectives into initiatives that drive growth opportunities

Director Risk Adjustment

Director Risk Adjustment

Responsibilities

Requirements

Skills

Director Risk Adjustment (Peak Health)

Responsibilities

Requirements

Skills

Technology Product Manager

Compensation

Responsibilities

Requirements

Skills

Director, Client Management & Strategy, Behavioral Health

Locations (3)

Responsibilities

Benefits

Skills

Benefits