Product Manager, Risk Adjustment Solutions

Job description

We are seeking a Product Manager to lead Risk Adjustment product capabilities across all lines of business, including Medicare Advantage, ACA Marketplace, and Medicaid. This role owns the execution and evolution of Risk Adjustment solutions within our population health platform, ensuring accurate risk capture, compliant submissions, and efficient coding workflows for health plans and provider organizations. The Product Manager will work closely with engineering, clinical coding teams, operations, and customer success teams, while collaborating with the Head of Platform on overall product strategy and roadmap direction. Responsibilities: Risk Adjustment Product Ownership 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 Regulatory & Program Monitoring: - Track CMS announcements and regulatory updates - Ensure timely platform updates...