4266- Senior Product Manager-Risk and Quality

Innovaccer
Noida
Workplace: OnsiteFull timeFunction: Product ManagementExperience: 5+ yearsSkills: ["Communication","Cross-functional collaboration","Regulatory fluency","Product strategy","Comfort with ambiguity"]

Lead development of Galaxy, an AI cloud for payer risk and quality performance. Own the product vision, strategy, and roadmap across risk adjustment, Stars/HEDIS quality management, and Fraud, Waste, and Abuse (FWA) program integrity. Build unified workflows and success metrics, partner with clinicians and subject-matter experts for CMS compliance, and collaborate cross-functionally with engineering, data science, design, and customer-facing teams to drive adoption and audit readiness.

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FursaFursa
Innovaccer
Innovaccer
1 month ago

4266- Senior Product Manager-Risk and Quality

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Last checked: 20 hours agoStatus: Live

Job Summary

Lead development of Galaxy, an AI cloud for payer risk and quality performance. Own the product vision, strategy, and roadmap across risk adjustment, Stars/HEDIS quality management, and Fraud, Waste, and Abuse (FWA) program integrity. Build unified workflows and success metrics, partner with clinicians and subject-matter experts for CMS compliance, and collaborate cross-functionally with engineering, data science, design, and customer-facing teams to drive adoption and audit readiness.
Location: Noida
Workplace: Onsite
Employment Type: Full time
Job Function: Product Management
Seniority: Manager level

Key Responsibilities

  • •Own Galaxy product vision, strategy, and roadmap across risk adjustment, quality management (Stars/HEDIS), and FWA.
  • •Partner with clinicians and subject matter experts to ensure clinical accuracy, coding integrity, and CMS compliance.
  • •Collaborate with engineering, data science, and design to deliver workflows for risk coders, quality analysts, SIU/FWA investigators, and medical management staff.
  • •Define and track success metrics such as RAF capture accuracy, care/quality gap closure rates, Stars performance, FWA detection precision, and audit readiness.
  • •Engage payer customers and monitor regulatory/industry updates (e.g., V28, RADV audit requirements, HEDIS updates, CMS interoperability rules) to adapt product direction.

Pay and Benefits

Perks:Health InsuranceParental LeaveSabbatical LeaveRemote Work

Key Requirements

  • •5–8+ years of product management experience, ideally in healthcare technology, based in India.
  • •Experience in payer operations, risk adjustment, quality (Stars/HEDIS), utilization management, or Fraud, Waste, and Abuse.
  • •Demonstrated experience using AI technologies in product development (e.g., clinical decision support, coding automation, anomaly detection).
  • •Strong understanding of CMS programs and regulatory frameworks (RAF/HCC, V28, RADV, HEDIS, prior authorization interoperability).
  • •Familiarity with healthcare data standards (FHIR, X12) and payer data ecosystems, plus clear communication across teams and time zones.
Experience:5+ yearsHealthcare technologyHealthcare dataPayer operationsAI in product development
Skills:CommunicationCross-functional collaborationRegulatory fluencyProduct strategyComfort with ambiguity
Tech Stack:AIFHIRX12

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