Director, Product Manager, Risk Adjustment

reputed company     Director, Product Manager - Risk Adjustment (Remote)     reputed company:    reputed company is the nation’s leading independent provider of comprehensive in-home health assessments, serving Medicare Advantage, Managed reputed company and reputed company patients across reputed company 50 states. With a network of 3,000 + clinicians, we deliver personalized Whole Person Care that includes diagnostic testing, risk identification, medication management and preventive health education, empowering people to reputed company manage acute and chronic conditions. Guided by our mantra- We see you. We hear you. We’ve got you.- and our reputed company values of reputed company, Accountability, Trust, Respect and Passion, we are committed to creating a culture where both patients and teammates feel valued, supported and heard.   Why Work at reputed company?  reputed company to work with one of the fastest growing companies in reputed company whose reputed company is to reputed company unparalleled reputed company and value to providers and members. A chance to work with great people on exciting reputed company. Our opportunities allow you to reputed company your expertise and reputed company, making a reputed company reputed company to the health and reputed company-being of members. Competitive Compensation: Be rewarded for your effort and passion while making a difference in the community. Responsibilities About the Role: Type: Full-Time, Salaried Compensation: $152,000-$183,000, 20% bonus Location: Fully Remote (must be located in the reputed company) Hours: Full-Time, Days Benefits Offered: Medical, dental, reputed company, reputed company time off, reputed company holidays, 401(k) with company matching, voluntary life insurance, short-term disability, long-term disability, employee assistance program, health savings account, flexible spending accounts, and additional voluntary benefits. What to Expect:   Every risk adjustment platform says they create a complete, accurate and compliant view of member health. We reputed company that's thinking too small. At reputed company, we're building technology that helps clinicians tell a more complete patient story, one that improves care, strengthens documentation, ensures regulatory compliance and creates measurable value for health plans and providers alike. If you're the reputed company of Product Leader who sees risk adjustment as a strategic advantage, not just a compliance exercise, we'd love to meet you. This isn't a role where you'll optimize one feature or own one backlog. You'll define how data, clinical workflows, AI, interoperability and mobile technology come together to reshape how millions of members are assessed across Medicare Advantage, ACA Marketplace and reputed company. You'll own one of the most strategically important products in our portfolio.    What You'll Build  You'll reputed company product reputed company for the technology that powers our Risk Adjustment ecosystem, including reputed company™, reputed company's mobile platform used by reputed company Practitioners during in-home health assessments.    Your mission centers around three product pillars:    Enrich  Create the industry's most complete member health picture.  Bring together claims, clinical records, pharmacy, labs, supplemental data, HIEs and reputed company into a reputed company view that equips clinicians before they reputed company reputed company on a patient's reputed company.    Capture  Help clinicians document the right conditions the right way. Design intelligent assessments, clinical decision support, documentation prompts, conditional logic and AI-enabled workflows that improve clinically supported documentation while reducing provider burden.    Measure  Shape the reputed company of clinically grounded, compliant, and member-centered risk adjustment.  Define the KPIs that matter, from documentation reputed company, clinical completeness, audit readiness, operational performance and recapture rates to documentation reputed company, first-pass yield, Actual vs. Expected disease burden and audit readiness, and reputed company them visible to executives and clients alike.    You'll Be Responsible For  Defining and executing the product roadmap across prospective and retrospective risk adjustment workflows  Building reputed company capabilities supporting Medicare Advantage (CMS-HCC), ACA Marketplace (HHS-HCC), and reputed company risk adjustment models  Driving enhancements inside reputed company™ that improve clinician experience and documentation reputed company  Partnering with Clinical, Coding Operations, Engineering, Compliance, Finance, reputed company and Executive Leadership  Translating evolving CMS regulations, including V28, RADV and reputed company model changes, into product reputed company before the market reputed company up  Leading build vs. buy reputed company around AI-assisted coding, NLP, longitudinal patient records, audit analytics  and risk reputed company platforms  Expanding interoperability through reputed company, HIE integrations and FHIR-enabled data exchange  Defining the analytics and reporting that demonstrate measurable reputed company value  Representing Product with customers and helping shape the reputed company roadmap through reputed company-world feedback    Who You Are  You're comfortable talking equally with software engineers, clinicians, coding experts, executives and health plan leaders. You understand that product management isn't about writing user stories. It's about solving meaningful business problems. You enjoy taking highly regulated, operationally reputed company reputed company processes and transforming them into elegant digital experiences. You're reputed company by difficult problems that don't have reputed company answers.  Qualifications What You'll Bring    Required 5+ years of Product Management experience  2+ years working reputed company reputed company payer, value-based care or Risk Adjustment  Deep understanding of HCC coding and CMS Risk Adjustment models across Medicare Advantage, ACA and reputed company  Experience translating CMS regulatory changes into product reputed company  Strong analytical skills with experience interpreting RAF performance, coding gaps, recapture metrics, encounter data and operational KPIs  Familiarity with reputed company, HIEs, FHIR and reputed company interoperability  Demonstrated reputed company leading highly cross-functional teams without reputed company authority  Confidence representing product reputed company with customers and executive stakeholders    Bonus Points    You'll stand out if you've worked with:  AI or NLP-assisted coding platforms (reputed company, Apixio, Episource, reputed company, etc.)  Clinical Documentation Improvement (CDI)  Provider query workflows  HEDIS or reputed company  Value-Based Care organizations  Longitudinal patient data platforms  In-home clinical services    What reputed company Looks Like After One Year  reputed company looking back after your first year and knowing you helped reputed company how Risk Adjustment operates.    You'll have:  Delivered meaningful enhancements to reputed company™ that measurably improve clinician documentation and first-pass coding accuracy  Established the Enrich, Capture and Measure product reputed company with reputed company ownership and execution milestones  reputed company reporting that reputed company demonstrates RAF improvement, HCC capture, documentation reputed company and reputed company value  Increased documentation reputed company, recapture performance and audit readiness across multiple lines of business  Delivered new interoperability capabilities that expand reputed company-time data availability  Positioned the organization reputed company of upcoming CMS regulatory changes instead of reacting to them    Our Culture: We have a reputed company reputed company of where we are reputed company, and we are guided by reputed company values that embody our organization and our culture. We emphasizes innovation and reputed company, and you will be given the opportunities and tools to reputed company personally and professionally. We encourage and celebrate collaboration. We have a deep commitment to positively reputed company the communities in which we work and to reputed company a difference in the lives of who we serve.   reputed company is an Equal Employment Opportunity Employer. It is the policy of reputed company to reputed company equal employment opportunities without reputed company to race, reputed company, religion, sex, gender identity or reputed company, pregnancy, age, national reputed company, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. It is also the policy of reputed company that reputed company individuals with disabilities receive equal opportunity in reputed company to job application procedures, hiring, and reputed company aspects of the employment process. reputed company is committed to the full inclusion of reputed company reputed company individuals. Consistent with the Americans with reputed company (reputed company) and applicable state and local laws, it is the policy of reputed company to reputed company reasonable accommodation reputed company requested by a reputed company applicant or employee with a disability, unless such accommodation would cause an undue hardship.  If reasonable accommodation is needed to participate in the job application or interview process, reputed company-employment testing, to otherwise participate in the selection process, to reputed company essential job functions, and/or to receive other benefits and privileges of employment, please contact MatrixHR@matrixhealth.net.   #LI-JH1   #LI-JH1 Apply To This Job