Technical Product Manager – Medicare Risk Adjustment Solutions
Job Description:
• Drive the functional and technical roadmap for risk adjustment systems
• Guide the technical implementation of risk adjustment solutions
• Anticipate regulatory and operational changes and integrate them into the roadmap
• Ensure quality, accuracy, and completeness of data used for risk adjustment
• Collaborate with internal and external coding, analytics, and clinical teams
• Translate CMS regulations into actionable business and system requirements
• Partner with vendors to manage technical solutions and integrations
• Assist with CMS Risk Adjustment Data Validation activities
Requirements:
• 5+ years of Product Management or Business Analyst experience in healthcare payer systems
• At least 3 years focused on Medicare Advantage, ACA, HCC models, and related coding and documentation guidelines
• Experience in healthcare operations, provider enablement, or working with health plans and risk adjustment vendors
• Proven hands-on expertise with Microsoft SQL, ETL Tools, Cloud Platforms
• Strong analytical, problem-solving, and communication skills
• Bachelor’s degree in Information Systems, Computer Science, Business, Healthcare Administration, or related field
• 4 years additional experience may be considered in lieu of education
• MBA or advanced degree preferred
Benefits:
• Health insurance
• Retirement plans
• Professional development
Apply tot his job
Apply To this Job
• Drive the functional and technical roadmap for risk adjustment systems
• Guide the technical implementation of risk adjustment solutions
• Anticipate regulatory and operational changes and integrate them into the roadmap
• Ensure quality, accuracy, and completeness of data used for risk adjustment
• Collaborate with internal and external coding, analytics, and clinical teams
• Translate CMS regulations into actionable business and system requirements
• Partner with vendors to manage technical solutions and integrations
• Assist with CMS Risk Adjustment Data Validation activities
Requirements:
• 5+ years of Product Management or Business Analyst experience in healthcare payer systems
• At least 3 years focused on Medicare Advantage, ACA, HCC models, and related coding and documentation guidelines
• Experience in healthcare operations, provider enablement, or working with health plans and risk adjustment vendors
• Proven hands-on expertise with Microsoft SQL, ETL Tools, Cloud Platforms
• Strong analytical, problem-solving, and communication skills
• Bachelor’s degree in Information Systems, Computer Science, Business, Healthcare Administration, or related field
• 4 years additional experience may be considered in lieu of education
• MBA or advanced degree preferred
Benefits:
• Health insurance
• Retirement plans
• Professional development
Apply tot his job
Apply To this Job