Product Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the strategy, design, and implementation of solutions for Medicare, Medicaid, and ACA Risk Adjustment programs.

• Collaborate with enterprise and customer stakeholders to enhance risk score accuracy, data completeness, and workflow efficiency.

• Establish risk adjustment product use cases and validate them through workflow analysis and Voice of Customer (VOC) sessions.

• Convert CMS, HHS, and state regulatory changes into product specifications and roadmap revisions.

• Propel product design focused on interoperability, supporting EHR/EMR and clinical data exchange.

• Work alongside engineering, clinical, and data teams to create scalable risk adjustment solutions, including suspecting models, chart review workflows, coding tools, clinical ingestion pipelines, and other modules.

• Assess risk adjustment use cases for AI/ML, automation, and workflow optimization potentials.

• Champion the voice of the customer by collecting feedback to enhance adoption and promote continuous improvement.

• Develop ROI models and business cases for new features, analytics, and interoperability enhancements.

• Direct analytics teams on exploratory risk adjustment analysis and translate findings into scalable product capabilities.

• Ensure that risk adjustment solutions adhere to interoperability compliance.

• Assist in implementations and program year transitions, ensuring that configuration changes are effectively deployed.

• Contribute to the long-term product strategy with a focus on scalability, interoperability, automation, and regulatory preparedness.

• Conduct annual performance reviews and/or goal-setting activities.

• Complete special projects and other assigned responsibilities.

• Guide teams and represent Cotiviti's interoperability expertise both internally and externally.

• Mentor others and lead without formal authority when necessary.

⛳️ Requirements

• A Bachelor's degree with strong academic performance in Health Sciences, Computer Science, Engineering, Economics, Mathematics, or another quantitative discipline.

• Over 3 years of experience in healthcare product management, analytics, consulting, or technology, including at least 2 years in developing risk adjustment products.

• Proven knowledge of risk adjustment and interoperability frameworks.

• Familiarity with CMS-HCC, HHS-HCC, and Medicaid Risk Adjustment models.

• Insight into EHR/EMR data and clinical interoperability.

• Understanding of clinical documentation, coding workflows, and provider specialty taxonomy.

• Comprehension of prospective and retrospective Risk Adjustment programs.

• Experience working with cross-functional, matrixed product teams in an agile setting.

• Proven experience in defining customer workflows and user stories.

• Exceptional communication and stakeholder management skills.

• Ability to translate regulatory and clinical requirements into technical solutions and articulate technical concepts to non-technical audiences.

• Strong problem-solving abilities with a record of driving initiatives from concept to execution.

• Leadership and mentoring skills.

• Must be able to provide a dedicated, secure work environment.

• Must be able to provide high-speed internet access and maintain office setup.

• Must be able to perform duties with or without reasonable accommodation.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Disability insurance.

• Life insurance coverage.

• 401(k) savings plans.

• Paid family leave.

• 9 paid holidays each year.

• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.

• Dedicated, secure work area.

• High-speed internet access and maintenance for office setup.