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

Innovaccer
United States
Workplace: RemoteFull timeFunction: Quality & Regulatory (Non-Software)Experience: 10+ yearsEducation: bachelorsSkills: ["Memo-writing","Executive presentation","Communication","Influence","Leadership","Mentoring"]

Own end-to-end product strategy, roadmap, and GTM execution for the payer portfolio spanning Risk Adjustment, RADV/Audit Readiness, Quality (HEDIS/Stars), and Compliance. Translate CMS/HHS/state regulatory requirements and clinical/financial risk workflows into an AI-native product platform that improves audit defensibility, revenue accuracy, and operational efficiency. Lead product managers, partner with Engineering/Data Science/Clinical SMEs, and drive measurable ROI outcomes.

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FursaFursa
Innovaccer
Innovaccer
3 days ago

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

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Last checked: 4 hours agoStatus: Live

Job Summary

Own end-to-end product strategy, roadmap, and GTM execution for the payer portfolio spanning Risk Adjustment, RADV/Audit Readiness, Quality (HEDIS/Stars), and Compliance. Translate CMS/HHS/state regulatory requirements and clinical/financial risk workflows into an AI-native product platform that improves audit defensibility, revenue accuracy, and operational efficiency. Lead product managers, partner with Engineering/Data Science/Clinical SMEs, and drive measurable ROI outcomes.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Quality & Regulatory (Non-Software)
Seniority: Sr. Director level

Key Responsibilities

  • •Own the multi-year product strategy and portfolio vision for Risk Adjustment (Prospective, Concurrent, Retrospective), RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products.
  • •Translate market needs into an AI-native roadmap using NLP/LLMs and automated coding/chart retrieval to reduce manual touchpoints and improve risk accuracy.
  • •Direct and develop product managers to unify risk analytics, chart review, coding workflows, and audit trail tools into a seamless product experience.
  • •Partner with Engineering, Data Science, Clinical SMEs, and Platform teams to build on Innovaccer’s Healthcare Intelligence Cloud and maintain predictable release cadence.
  • •Define outcome-based success metrics (e.g., chart review accuracy, suspecting yield, RADV audit mitigation, coding velocity) and co-own GTM execution with Sales/Pre-Sales/Customer Success.

Pay and Benefits

Perks:Paid LeaveParental LeaveHealth InsuranceDentalVisionDisability InsuranceLife InsuranceLegal AidPet Insurance

Key Requirements

  • •10+ years in Product Management or related technology leadership, including 5+ years building and scaling Risk Adjustment, RADV/Audit, or Quality solutions for health plans/payers.
  • •Deep expertise in Risk Adjustment and compliance workflows, including CMS-HCC, RxHCC, HHS-HCC, ICD-10, MEAT criteria, and retrospective chart reviews.
  • •Proven ability to ship AI/ML capabilities into healthcare workflows, including NLP for unstructured documentation, predictive suspecting models, and generative summaries for coders.
  • •Demonstrated success embedding SaaS products at enterprise scale within complex payer environments and multi-payer systems.
  • •Strong people leadership experience hiring, mentoring, and scaling product teams while fostering ownership and AI adoption.
Experience:10+ yearsHealthcareSaaSRisk adjustmentPayer
Education:Bachelor's
Skills:Memo-writingExecutive presentationCommunicationInfluenceLeadershipMentoring
Tech Stack:AIAI/MLNLPLLMsSaaSICD-10CMS-HCCRxHCCHHS-HCCMEAT criteriaHEDISStarsRADVRisk analyticsChart reviewCoding workflowsAutomated chart retrieval/coding enginesPredictive suspecting modelsGenerative summaries

Company Brief

Innovaccer
Provides a healthcare data activation platform that unifies clinical, claims, and operational data to enable analytics, care management, population health, and value-based care initiatives for providers, payers, and life sciences organizations.
Industry: HealthTech
Company Size: Enterprise (1,001+ employees)
Growth: Scaleup
Valuation: Unicorn (USD 1B+)
Funding: Series D
Headquarters: San Francisco, United States
Founded: 2014
WebsiteLinkedIn