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

About the Role

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.
A Day in the Life

1. Product Strategy & Domain Leadership (Risk & Quality)

- End-to-End Portfolio Vision: Own the multi-year product strategy for Risk Adjustment (Prospective, Concurrent, and Retrospective), RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products.

- AI-First Innovation: 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.

- Regulatory Agility: 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.

- Strategic Alignment: 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.

2. Execution, Architecture & AI-Native Product Craft

- Harmonized Suite: Direct and develop product managers to unify risk analytics, suspecting, chart review, coding workflows, and audit trail tools into a single, seamless product experience.

- AI-Native Operational Rigor: Enforce an AI-first development lifecycle—from discovery and automated feedback synthesis to generative prototyping and intelligent backlog management.

- Delivery & Quality: 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.

- Impact & ROI Metrics: 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.

3. Customer, GTM & Market Engagement

- Executive Single Point of Contact (SPOC): 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.

- GTM Enablement & Revenue Co-Ownership: 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.

- Industry Representation: Represent Innovaccer ’s Risk Adjustment perspective in external forums, industry advisory boards, and regulatory consultations.

What You Need

- Experience: 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.

- Domain Mastery: 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.

- AI & Data Fluency: 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