Senior Director of Product Management - Risk & Quality (Payer)

Innovaccer Analytics

3d

About The Position

Reporting to executive leadership, the Senior Director of Product Management – Risk & Quality is a key leader within Innovaccer’s Payer vertical. In this role, you will hold end-to-end accountability for the product strategy, roadmap, and go-to-market (GTM) execution across our Risk Adjustment, RADV/Audit Readiness, Quality (HEDIS/Stars), and Compliance solution portfolio. We are looking for a seasoned product leader who possesses deep domain expertise in clinical and financial risk operations across Commercial (ACA), Medicare Advantage, and Managed Medicaid markets. You will translate complex regulatory requirements, coding workflows, and risk-capture dynamics into a market-leading, AI-native product platform that drives verifiable revenue accuracy, audit defensibility, and operational efficiency for our health plan partners.

Requirements

• 10+ years in Product Management or related technology leadership roles, with at least 5+ years of direct experience building and scaling Risk Adjustment, RADV/Audit, or Quality solutions for health plans/payers.
• Deep expertise in Risk Adjustment methodologies (CMS-HCC, RxHCC, HHS-HCC), coding workflows (ICD-10, MEAT criteria), retrospective chart reviews, prospective point-of-care nudges, and RADV audit prep.
• Proven track record of shipping AI/ML capabilities into healthcare workflows (e.g., NLP for unstructured clinical documentation, predictive suspecting models, generative summaries for coders).
• Demonstrated success in shipping and embedding SaaS products within complex payer environments and multi-payer enterprise systems.
• Strong track record of hiring, mentoring, and scaling high-performing product management teams while fostering a culture of ownership and AI adoption.
• Exceptional memo-writing and executive presentation skills; comfortable discussing risk models with actuaries, NLP accuracy with data scientists, and ROI with CFOs.
• Bachelor’s degree in Computer Science, Health Informatics, Business, or related quantitative field required.

Nice To Haves

• Master’s/Advanced degree preferred.

Responsibilities

• Own the multi-year product strategy for Risk Adjustment (Prospective, Concurrent, and Retrospective), RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products.
• Translate market needs into an AI-native product roadmap—leveraging NLP, LLMs, and automated chart retrieval/coding engines to eliminate manual touchpoints and maximize risk accuracy.
• Stay ahead of evolving CMS, HHS, and state regulatory landscapes (e.g., V28 model updates, RADV audit rule changes, submission deadlines) to ensure continuous product compliance and market differentiation.
• Partner with VP Payer, CPO, and Market President- Payer Growth to shape the overall Payer product narrative and co-own revenue targets for your products.
• Direct and develop product managers to unify risk analytics, suspecting, chart review, coding workflows, and audit trail tools into a single, seamless product experience.
• Enforce an AI-first development lifecycle—from discovery and automated feedback synthesis to generative prototyping and intelligent backlog management.
• Partner closely with Engineering, Data Science, Clinical SMEs, and Platform teams to build scalably on Innovaccer's Healthcare Intelligence Cloud, maintaining a predictable release cadence.
• Establish strict outcome-based success metrics (e.g., chart review accuracy, suspecting yield rates, RADV audit mitigation rate, coding velocity) and track customer value realization.
• Build direct relationships with plan executives (CMOs, Chief Risk Officers, Actuarial Leads, VPs of Risk Adjustment) to understand operational pain points and serve as the product authority for strategic discussions and escalations.
• Collaborate with Sales, Pre-Sales, and Customer Success to refine sales pitches, participate in key customer pursuits, support upsell/cross-sell initiatives, and validate product-market fit.
• Represent Innovaccer’s Risk Adjustment perspective in external forums, industry advisory boards, and regulatory consultations.

Benefits

• Generous Paid Time Off: 20 days of fixed time off per year, in addition to company holidays
• Best-in-Class Parental Leave
• Recognition & Rewards: Monetary incentives and company-wide recognition
• Comprehensive Insurance Coverage: medical, dental, and vision insurance
• 100% company-paid short- and long-term disability and basic life insurance
• Optional perks: discounted legal aid and pet insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior