Product Manager, Risk Adjustment Solutions at Vatica Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

21 Jun, 26

Salary

100000.0

Posted On

23 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Risk Adjustment, Product Management, Medicare Advantage, ACA Marketplace, Medicaid, HCC Models, Risk Score Computation, Encounter Data Reconciliation, Product Strategy, Roadmap Planning, Regulatory Monitoring, Workflow Design, Backlog Prioritization, Stakeholder Management, Emotional Intelligence, Resourcefulness

Industry

Hospitals and Health Care

Description

We are seeking a Product Manager to lead Risk Adjustment product capabilities across all lines of business, including Medicare Advantage, ACA Marketplace, and Medicaid. This role owns the execution and evolution of Risk Adjustment solutions within our population health platform, ensuring accurate risk capture, compliant submissions, and efficient coding workflows for health plans and provider organizations. The Product Manager will work closely with engineering, clinical coding teams, operations, and customer success teams, while collaborating with the Head of Platform on overall product strategy and roadmap direction. Responsibilities: Risk Adjustment Product Ownership Own development and management of core Risk Adjustment capabilities including: HCC model updates and configuration Risk score computation across supported models Suspect generation and accuracy management Encounter data reconciliation Risk adjustment reporting and analytics Ensure platform support for Medicare Advantage (CMS-HCC) ACA Marketplace (HHS-HCC) Medicaid risk adjustment models Regulatory & Program Monitoring Track CMS announcements and regulatory updates Ensure timely platform updates aligned with HCC model changes Monitor LOB-specific submission timelines and program requirements Work closely with clinical coding teams and outbound operations teams to support operational readiness Product Development & Enhancements Identify and define new feature enhancements Design product workflows and requirements Maintain and prioritize product backlog Work with engineering teams and TPMs to track development progress Validate completed features prior to release Client & Customer Success Collaboration Work closely with Customer Success teams to understand client workflows and challenges Participate in client discussions when needed Translate client feedback into product improvements and roadmap priorities Product Strategy Collaboration Work in close collaboration with the Head of Platform to align Risk Adjustment capabilities with overall platform strategy Provide domain expertise and product insights to inform roadmap planning 5+ years Product Management experience 5+ years experience with Risk Adjustment or Population Health technology Strong understanding of Medicare Advantage, ACA, or Medicaid risk programs Familiarity with HCC models and coding workflows Experience collaborating with engineering teams on healthcare platforms Competencies: Communicates Effectively Exchanging ideas, knowledge, and data so that the message is received and understood with clarity and purpose. Leverages emotional intelligence to adapt to the emotions and intentions of others. Plans and Aligns, Resourcefulness Plans and prioritizes work to meet the goals of the business. Breaks down objectives into plans and actions to achieve significant milestones. Anticipates and readily adjusts plans. Maintains organization of resources to support efficiency. Business Insight & Organizational Savvy Ensures work and tasks are aligned to meet company priorities. Breaks down goals into actions with milestones. Understands how to navigate the company and connect with key stakeholders or contributors. Collaborates Identifies and builds partnerships to meet shared goals. Readily partners with others to meet objectives and shares credit for contributions. Demonstrates cooperation that earns support of others. Balances Stakeholders & Manages Conflict Anticipating and balancing the needs of multiple stakeholders and multiple projects. Highly prepared and knowledgeable about expectations. Delivers fair and flexible response to stakeholder needs. Handling conflict situations to resolution effectively and professionally. Applies fair decision-making to balance competing interest mediating any points of abrasion. Situational Adaptability & Flexibility Adapts approach in real time to respond to different situations. Thinks quickly and readily adapts behavior in the moment. High level of versatility. WORKING AT VATICA HEALTH ADVANTAGES Prosperity Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded 401k plans– we want to empower you to prepare for your future Room for growth and advancement- we love our employees and want to develop within Good Health Comprehensive Medical, Dental, and Vision insurance plans Tax-free Dependent Care Account Life insurance, short-term, and long-term disability Happiness Excellent PTO policy (everyone deserves a vacation now and then) Great work-life balance environment- We believe family comes first! Strong supportive teams- There is always a helping hand when you need it The salary for a position is typically determined by multiple factors such as the individual's qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $80,000 to $100,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered.

Responsibilities

This role involves owning the development and management of core Risk Adjustment capabilities, including HCC model updates, risk score computation, suspect generation, and reporting across Medicare Advantage, ACA Marketplace, and Medicaid lines of business. The Product Manager must also track regulatory updates and ensure timely platform alignment with changes and submission timelines.