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Innovaccer seeks a Senior Director of Product Management to lead the Risk & Quality portfolio for its Payer vertical. Reporting to executive leadership, you will own end-to-end product strategy, roadmap, and go-to-market execution across Risk Adjustment, RADV/Audit Readiness, Quality (HEDIS/Stars), and Compliance solutions.
You will translate complex regulatory requirements, coding workflows, and risk-capture dynamics into an AI-native product platform that drives revenue accuracy, audit defensibility, and operational efficiency for health plan partners. The role requires deep domain expertise in clinical and financial risk operations across Commercial (ACA), Medicare Advantage, and Managed Medicaid markets.
Key responsibilities include:
**Product Strategy & Domain Leadership**: Own multi-year strategy for Risk Adjustment (Prospective, Concurrent, Retrospective), RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products. Build an AI-first innovation roadmap leveraging NLP, LLMs, and automated chart retrieval/coding engines. Stay ahead of evolving CMS, HHS, and state regulatory landscapes. Partner with VP Payer, CPO, and Market President to shape overall Payer product narrative and co-own revenue targets.
**Execution & AI-Native Product Craft**: Direct and develop product managers to unify risk analytics, suspecting, chart review, coding workflows, and audit trail tools into a seamless experience. Enforce an AI-first development lifecycle from discovery through intelligent backlog management. Partner with Engineering, Data Science, Clinical SMEs, and Platform teams to build on Innovaccer's Healthcare Intelligence Cloud. Establish outcome-based success metrics (chart review accuracy, suspecting yield rates, RADV audit mitigation rate, coding velocity).
**Customer & GTM Engagement**: Build direct relationships with plan executives (CMOs, Chief Risk Officers, Actuarial Leads, VPs of Risk Adjustment). Collaborate with Sales, Pre-Sales, and Customer Success on sales enablement and upsell/cross-sell initiatives. Represent Innovaccer's Risk Adjustment perspective in external forums and industry advisory boards.
Required qualifications: 10+ years in Product Management or technology leadership, with 5+ years building and scaling Risk Adjustment, RADV/Audit, or Quality solutions for health plans. Deep expertise in Risk Adjustment methodologies (CMS-HCC, RxHCC, HHS-HCC), coding workflows (ICD-10, MEAT criteria), retrospective chart reviews, and RADV audit prep. Proven track record shipping AI/ML capabilities into healthcare workflows (NLP for clinical documentation, predictive models, generative summaries). Demonstrated success embedding SaaS products in complex payer environments. Strong people leadership experience scaling high-performing product teams. Exceptional communication and executive presentation skills. Bachelor's degree in Computer Science, Health Informatics, Business, or related quantitative field required; Master's/Advanced degree preferred.
