Become a part of our caring community and help us put health first
 

The Program Delivery Principal strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

The Program Delivery Principal – Risk Adjustment Operations Workflow Transformation is responsible for the strategic oversight and delivery of technology solutions that drive the effectiveness and efficiency of risk adjustment operations. This role will focus on delivering solutions to optimize retrieval and coding processes, enhance data handling and sharing capabilities, and establish scalable AI use cases across the risk adjustment lifecycle. The ideal candidate will have demonstrated experience leading matrixed teams, influencing cross-functional decisions, driving governance, and delivering complex initiatives within a regulated healthcare environment. This position reports to the Associate VP, Risk Adjustment.

Use your skills to make an impact
 

Key Responsibilities:

• Provide vision, leadership, and direction for multi-disciplinary program teams focused on risk adjustment operations workflow transformation.
• Develop and execute program strategies that optimize medical record retrieval, coding accuracy, and data sharing across business and technology stakeholders.
• Identify and implement innovative AI use cases to improve risk adjustment outcomes, including automation, predictive analytics, and process optimization.
• Oversee program planning, execution, risk management, and delivery across multiple workstreams, ensuring alignment with organizational goals and compliance standards.
• Cultivate strong relationships with internal partners, technology vendors, and executive leadership to drive consensus and successful program adoption.
• Lead program governance, including the establishment and execution of frameworks, performance metrics, and reporting processes.
• Drive continuous improvement initiatives, change management, and best practices across all facets of risk adjustment operations workflow.
• Manage program budgets, resources, and timelines to achieve desired outcomes.
• Prepare and deliver presentations and updates to senior and executive leadership.
• Proactively monitor and evaluate emerging industry trends, regulatory changes, and technological advancements—particularly in risk adjustment, data management, and AI—ensuring program strategies remain innovative, competitive, and aligned with best practices and compliance requirements.

Required Qualifications:

• Bachelor’s degree in information technology, business administration, healthcare, or related field.
• 5+ years of experience delivering complex technology programs or projects, preferably within risk adjustment or healthcare operations.
• Demonstrated experience with governance frameworks and executive-level reporting.
• Proven ability to lead and influence matrixed, cross-functional teams in a highly regulated environment.
• Strong understanding of risk adjustment processes, data management, and coding standards.
• Experience in the design and delivery of technology solutions, including AI/ML applications in healthcare.
• Excellent analytical, organizational, and communication skills.

Preferred Qualifications:

• Master’s degree in a related field.
• PMP, Agile, or Six Sigma certification.
• Prior experience with risk adjustment data retrieval, coding platforms, and AI-enabled healthcare solutions.

Additional Information:

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application pres