About Taro Health
Taro Health is a team of healthcare nerds, software engineers, product designers, direct primary care doctors, health insurance experts, and more. We are building a healthcare system that makes sense, starting by redefining the role of health insurance – one that focuses on reducing friction for doctors and patients, and investing in ways to create more meaningful doctor-patient relationships.
We believe unrushed conversations with doctors lead to better health and lower costs for patients. Our health plans enable all members to have free and frictionless access to a dedicated doctor they know and trust. We’re excited to create health insurance plans you can actually use.
We’re backed by top investors and are looking for values-aligned individuals to join our NYC-based founding team.
Description
This position will play a pivotal role in shaping our risk adjustment strategies and ensuring compliance as we expand and grow. This position requires a dynamic individual who can navigate the challenges of a startup environment, lead cross-functional teams, and implement effective risk adjustment methodologies. On any given day, you may work with a doctor, work with internal data and engineering, work with a vendor, or review a claim – you will be deep in the weeds! If you thrive in fast-paced settings and have a strong analytical mindset, we want to hear from you!
Your responsibilities will include:
- Boots On The Ground Execution: Daily execution of core risk adjustment tasks and managing the priorities. This is an IC role to start, but as the company evolves, our hope is that you will scale this organization.
- Data-Driven Analysis: Conduct thorough analyses of claims and enrollment data to identify trends and opportunities for enhancing risk scores and improving member outcomes.
- Cross-Functional Collaboration: Partner with clinical, operations, and technology teams to ensure accurate documentation and data integrity.
- Performance Metrics: Establish KPIs to monitor the effectiveness of our risk adjustment initiatives, adjust strategies based on data insights, and close any gaps.
- Regulatory Compliance: Stay abreast of regulatory requirements related to risk adjustment and ensure that our practices comply with CMS guidelines.
- Stakeholder Engagement: Communicate findings and strategies to leadership and stakeholders, preparing reports that highlight the impact of risk adjustment efforts.
- Innovative Solutions: Identify and implement process improvements and technological innovations that enhance our risk adjustment capabilities.
- Strategic Leadership: Develop and execute risk adjustment programs that align with our growth objectives and position us competitively within the market.
Your potential qualifications:
- Bachelor’s degree in Health Administration, Business Administration, or a related field; Master’s degree preferred.
- 3-5 years of experience in healthcare program management, risk adjustment, or related roles within a health insurance context, preferably in a startup or fast-paced environment.
- Strong understanding of risk adjustment methodologies, including HCC (Hierarchical Condition Category) coding and reimbursement models.
- Proficiency in data analysis tools and the ability to extract actionable insights from complex datasets.
- Excellent project management skills, with a proven ability to manage multiple priorities and adapt to changing circumstances.
- Strong communication and interpersonal skills, capable of engaging diverse teams and stakeholders effectively.
- Knowledge of healthcare regulations and compliance requirements related to risk adjustment.
What We Offer
- Remote or hybrid work set-up
- Flexible Paid Time Off
- Multiple company and team onsite events across NYC and cities in our supported markets each year
You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
