The setting
's is a platform for virtual care that combines care teams, coaching, a mobile app, and connected devices. It supports care for diabetes, prediabetes, high blood pressure, and muscle and joint problems.
Outcome-linked fees need a rule that buyers can reconcile and Finance can carry.
Employer confidence depends on transparent measurement, while reserve exposure depends on terms that do not overpromise.
Who you’d be doing this for
“My CFO asked which members count, and I had to say we’re still lining that up.”
Anjali Singh · Population Health Manager · a character in this brief
Leads chronic-condition program performance for a self-insured employer evaluating whether to place fees at risk.
What is at stake
Employer buyers are asking for at-risk fees they can reconcile to their own member records. You must weigh a usable first pilot against financial exposure that cannot be measured cleanly.
Why it isn’t already fixed
Every obvious fix costs something else. That’s the part you’d have to decide.
- buyer-verifiable outcomes vs financial exposure
- simple customer terms vs clinically credible measurement
- pilot speed vs reusable controls
- shared accountability vs controllable reserves
Why Omada Health
The B2B2C enrollment funnel and member outcomes make employer payment terms depend on records across eligibility, outreach, enrollment, and care.
Written with these in mind
Not your kind of problem? 10 more at Omada Health, or browse every organization.
Where the organization context comes fromThe postings this brief was written from, and the reporting read before it.
The organization context comes from public information. The situation and characters are written for the brief.
Job postings it was written from
Public descriptions of the work at Omada Health. They are listed as sources, not as openings. The lines under a posting are its own words, where it meets this brief.
- Senior Manager, Revenue Operations · no longer posted
- You'll own the end-to-end B2B2C enrollment funnel—from eligibility through outreach to member enrollment—building the data, metrics, and operating cadence that drive measurable growth.
- Own enrollment funnel reporting across eligibility, outreach, and member conversion.
- Principal Actuary · no longer posted
- You will bring actuarial rigor to savings and ROI methodology, performance guarantees, and at-risk arrangements.
- Build pricing and exposure models, define clear triggers and measurement terms, and establish actuarial guardrails for customer commitments.
- Senior Director, Capacity Planning, Workforce Operations & Analytics (opens in a new tab)
- Own capacity planning and staffing models that support Health Coaching, Cardiometabolic Specialists, Physical Activity Specialists, Behavioral Health, Member Support and Member Navigation, ensuring accurate, efficient coverage at sustainable cost‑to‑serve.
- Lead cross‑functional initiatives that connect the department’s workstreams to broader company priorities (e.g., cost of revenue and gross margin targets, member experience redesign, AI‑enabled workflows), ensuring care team operations and analytics are integrated into enterprise plans.
- Senior Director, Sales and Revenue Operations (opens in a new tab)
Reporting read before this brief was written
The pieces closest to the situation in this brief.
At its September 10, 2026 Investor Day, Omada Health said its customers face costs rising faster than in 20 years, are wrestling with how to handle GLP-1s, and are raising expectations for evidence while consolidating to fewer partners.
Omada Health (OMDA) Transcript: Investor Day 2026 (opens in a new tab) · stockanalysis.com · Sep 10, 2026
PHTI's 2026 State of Digital Health Purchasing survey, published September 29, 2026, found that 68% of employers and 55% of health plans currently use performance-based contracts for digital health tools, and 31% of such contracts put more than half of fees at risk.
PHTI Survey Finds Majority of Employers and Health Plans Are Using Performance-Based Contracting to Pay for Digital Health Tools (opens in a new tab) · phti.org · Sep 29, 2026
In July 2026, CMS proposed that Medicare pay for remote physiologic and therapeutic monitoring only when furnished by the billing practice's own clinical staff, effective January 1, 2027, which would end third-party vendor arrangements.
States fund RPM expansion while Medicare considers new limits (opens in a new tab) · fiercehealthcare.com · Sep 14, 2026
This is the setup. The work is inside.
Running it puts you in the room: the full situation and its constraints, stakeholders who push back in their own words, and the decisions that are yours to make. What you produce becomes a Day One Plan — work you can show someone instead of describing.
Where similar work appears
Other live briefs connected to this one, and what connects them.
Similar problems at other organizations
Like this one, each of these turns on committing to a deal before it checks out.
Employers are asking to hold back part of MSK fees when enrollment or outcomes fall short.
You have to weigh a compelling commercial commitment against measures that clinical, legal, and buyers can defend.
Finance and clinical reviewers rejected the first payment schedule because they dispute whether outcomes can be fairly attributed.
You need to weigh downside protection against measures that preserve appropriate member access and withstand validation.
A major employer will tie at least 25% of its MSK fees to performance or open the benefit to competing vendors.
You must weigh an enrollment promise buyers can verify against a claims-savings promise that carries more commercial upside.
The same setting, from another role
Each is set around Omada Health’s Omada Platform, written for a different role. They’re separate briefs, not the same scenario.
Enterprise opportunities are waiting on tailored follow-up while sellers rebuild discovery context and verify claims.
You must decide what AI can prepare and what a seller must review before anything reaches a buyer.
Employers want GLP-1 support but are consolidating chronic-condition vendors.
You must weigh a focused broker package against the proof and flexibility buyers need.
A 180,000-life employer deal is splitting over access, fee risk, and proof of outcomes.
You must weigh contract certainty against the member reach that makes the program commercially meaningful.
Other problems with a similar purpose
In each of these, as in this one, the aim is to turn a complicated, unpredictable operation into something customers can count on to arrive on time.
Northern Mexico fleet installs are being booked with vehicle lists that do not match the installer’s assignment.
You must protect appointment speed without sending partners incomplete work.
Incomplete first shipments are entering the receiving exception queue and delaying brand activation.
You have to weigh a tighter readiness check against the need to get qualified brands live quickly.
Only 68% of invited employees make a first card purchase within 48 hours.
You have to weigh faster activation against keeping entity assignment and spend controls accurate.
