Senior Director of Product Management – Risk & Quality

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

📋 Description

• Take ownership of the comprehensive, multi-year product strategy for Risk Adjustment, RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products.

• Transform market demands into an AI-driven product roadmap utilizing NLP, LLMs, and automated chart retrieval/coding engines.

• Keep track of CMS, HHS, and state regulatory developments to ensure product compliance and market uniqueness.

• Collaborate with the VP Payer, CPO, and Market President—Payer Growth to cultivate the Payer product narrative and jointly manage revenue objectives.

• Guide and mentor product managers to streamline risk analytics, suspecting, chart review, coding workflows, and audit trail tools.

• Implement an AI-centric product development lifecycle that encompasses discovery, automated feedback synthesis, generative prototyping, and intelligent backlog management.

• Partner with Engineering, Data Science, Clinical SMEs, and Platform teams to enhance Innovaccer’s Healthcare Intelligence Cloud.

• Set outcome-based metrics such as chart review accuracy, suspecting yield rates, RADV audit mitigation rates, and coding velocity.

• Build connections with plan executives like CMOs, Chief Risk Officers, Actuarial Leads, and VPs of Risk Adjustment.

• Act as the product authority for strategic conversations and escalations.

• Work in conjunction with Sales, Pre-Sales, and Customer Success on sales presentations, customer engagements, upsell/cross-sell initiatives, and validating product-market fit.

• Represent Innovaccer’s perspective on Risk Adjustment at external forums, industry advisory boards, and regulatory consultations.

⛳️ Requirements

• Over 10 years of experience in Product Management or related technology leadership roles.

• A minimum of 5 years of hands-on experience in developing and scaling Risk Adjustment, RADV/Audit, or Quality solutions for health plans/payers.

• In-depth knowledge of Risk Adjustment methodologies (CMS-HCC, RxHCC, HHS-HCC).

• Proficiency in coding workflows (ICD-10, MEAT criteria).

• Familiarity with retrospective chart reviews, prospective point-of-care nudges, and RADV audit preparation.

• Proven success in integrating AI/ML capabilities into healthcare workflows.

• Experience with NLP for unstructured clinical documentation, predictive suspecting models, or generative summaries for coders.

• Demonstrated achievement in deploying and embedding SaaS products within intricate payer environments and multi-payer enterprise systems.

• Strong history of recruiting, mentoring, and developing high-performing product management teams.

• Exceptional skills in memo-writing and executive presentations.

• Bachelor’s degree in Computer Science, Health Informatics, Business, or a related quantitative field is required.

• A Master’s/Advanced degree is preferred.

• Must be employed by Innovaccer Inc. in the U.S. and eligible to work in the United States, as employment eligibility is verified through E-Verify.

🏝️ Benefits

• 20 days of fixed paid time off annually, in addition to company holidays.

• Generous parental leave policy.

• Financial incentives and company-wide recognition for contributions and commitment.

• Comprehensive medical, dental, and vision insurance.

• 100% company-paid short- and long-term disability insurance.

• 100% company-paid basic life insurance.

• Discounted legal assistance.

• Pet insurance available.