Risk Adjustment Performance Consultant

The Risk Adjustment Performance Consultant provides advisory and performance improvement services to healthcare organizations, helping customers strengthen their risk adjustment practices and accurately reflect the clinical complexity of their patient populations. The role works directly with clinical and operational leaders, providers, coding teams, and value-based care stakeholders to establish priorities, develop tailored strategies, and guide sustainable improvements in documentation, workflows, and technology adoption.

Responsibilities include assessing current risk adjustment practices, understanding payer and contract priorities, and recommending improvements to patient outreach, pre-visit planning, Annual Wellness Visits, and review of prior-year and suspected conditions. The consultant delivers organizational education and targeted provider coaching on HCC concepts, appropriate coding, and clinically supported documentation. Chart-review findings and provider-specific examples inform practical guidance that helps care teams improve documentation quality within their daily workflows.

The consultant guides effective use of Oracle Health solutions, including Diagnosis Insights and related risk adjustment tools, and helps customers incorporate available features into their operations. Performance analysis supports the identification of priority populations, providers, and education needs. The role establishes performance baselines, develops scorecards and recommendations, conducts regular customer progress reviews, and adjusts strategies based on results throughout the performance year.

The position requires 6-8 years experience in risk adjustment, HCC documentation and coding, provider education, or value-based care consulting. Strong facilitation, communication, analytical, and relationship-management skills are essential, along with the ability to assess operational challenges and guide customer teams through improvement efforts. Knowledge of payer contracts and risk models across Medicare, Medicare Advantage, Medicaid, and commercial populations is valuable. Familiarity with Oracle Health workflows and population health solutions is preferred.

Disclaimer:
Certain U.S. based or U.S. customer or client-facing roles may be required to comply with applicable requirements, such as immunization/occupational health mandates, and/or drug testing requirements.
Range and benefit information provided in this posting are specific to the stated locations only
US: Hiring Range in USD from: $95,000 to $209,500 per annum. May be eligible for bonus and equity.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
As part of Oracle's onboarding process and consistent with applicable law, US-based employees are required to complete identity verification, which involves the collection and processing of their biometric information. Accommodations to this requirement may be granted following an individualized assessment.