Product Manager, Risk Adjustment Solutions
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Job Description
Product Manager leading Risk Adjustment product capabilities across Medicare Advantage, ACA, and Medicaid. Collaborating on product strategy and ensuring compliance with healthcare regulations.
Responsibilities:
- Own development and management of core Risk Adjustment capabilities including:
- HCC model updates and configuration
- Risk score computation across supported models
- Suspect generation and accuracy management
- Encounter data reconciliation
- Risk adjustment reporting and analytics
- Ensure platform support for:
- Medicare Advantage (CMS-HCC)
- ACA Marketplace (HHS-HCC)
- Medicaid risk adjustment models
- Track CMS announcements and regulatory updates
- Ensure timely platform updates aligned with HCC model changes
- Monitor LOB-specific submission timelines and program requirements
- Identify and define new feature enhancements
- Design product workflows and requirements
- Maintain and prioritize product backlog
- Work with engineering teams and TPMs to track development progress
- Validate completed features prior to release
- Work closely with Customer Success teams to understand client workflows and challenges
- Translate client feedback into product improvements and roadmap priorities
- Work in close collaboration with the Head of Platform to align Risk Adjustment capabilities with overall platform strategy
Requirements:
- 5+ years Product Management experience
- 5+ years experience with Risk Adjustment or Population Health technology
- Strong understanding of Medicare Advantage, ACA, or Medicaid risk programs
- Familiarity with HCC models and coding workflows
- Experience collaborating with engineering teams on healthcare platforms
Benefits:
- Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
- Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
- 401k plans– we want to empower you to prepare for your future
- Room for growth and advancement- we love our employees and want to develop within
- Comprehensive Medical, Dental, and Vision insurance plans
- Tax-free Dependent Care Account
- Life insurance, short-term, and long-term disability
- Excellent PTO policy (everyone deserves a vacation now and then)
- Great work-life balance environment- We believe family comes first!
- Strong supportive teams- There is always a helping hand when you need it
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