Director, Risk Adjustment Products

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director, Risk Adjustment Products in United States.

This leadership role offers the opportunity to shape the future of risk adjustment technology within a rapidly evolving healthcare environment. You will drive the vision, strategy, and execution of innovative products that improve coding accuracy, provider engagement, and operational efficiency for health plans and risk-bearing organizations. Working at the intersection of product management, AI/ML innovation, interoperability, and healthcare compliance, you will collaborate closely with engineering, data science, operations, and clinical teams to deliver scalable, data-driven solutions. The position combines strategic influence with hands-on product leadership, making it ideal for a forward-thinking professional passionate about healthcare transformation. You will also play a key role in mentoring product teams and fostering a culture of innovation, collaboration, and continuous improvement in a fully remote environment.

Accountabilities:

• Lead the strategy, roadmap, and lifecycle management of retrospective and concurrent risk adjustment product solutions.
• Define multi-year product plans aligned with customer needs, CMS regulations, interoperability standards, and market trends.
• Identify and prioritize AI/ML-driven use cases that improve suspecting accuracy, coding opportunities, and provider workflows.
• Partner with Engineering and Data Science teams to build predictive models, real-time data pipelines, and scalable interoperability solutions.
• Ensure products maintain compliance, audit readiness, clinical integrity, and defensibility across all workflows and outputs.
• Collaborate with internal stakeholders and external healthcare clients to gather feedback, improve product adoption, and enhance customer outcomes.
• Establish and monitor KPIs related to coding accuracy, provider engagement, interoperability success, and risk score impact.
• Present product strategies, roadmap updates, and operational recommendations to executive leadership and advisory groups.
• Lead, mentor, and grow a team of Product Managers while promoting best practices, experimentation, and continuous learning.
• Drive cross-functional collaboration across legal, compliance, revenue management, coding, operations, and technology teams.

Requirements:

• Bachelor’s degree in Business, Healthcare, Technology, or a related field required; Master’s degree preferred.
• 10+ years of experience in Risk Adjustment product management, including strategy development and roadmap execution.
• 5+ years of leadership experience managing and developing high-performing teams.
• Strong understanding of risk adjustment methodologies including HCCs, CRGs, CMS models, and commercial payer frameworks.
• Experience with interoperability, chart retrieval solutions, medical record review, and digital healthcare workflows.
• Proven experience working with AI-driven products, predictive analytics, and cloud-based environments such as AWS.
• Familiarity with Agile methodologies, APIs, SQL, Core Java, Spring Boot, CI/CD pipelines, and modern software development practices.
• Strong analytical, organizational, and strategic thinking capabilities with the ability to balance compliance and innovation.
• Excellent communication and stakeholder management skills with experience working across technical and non-technical teams.
• Ability to thrive in fast-paced, evolving environments while managing multiple priorities in a fully remote setting.

Benefits:

• Fully remote position available anywhere within the United States.
• Competitive annual base salary ranging from $170,000 to $225,000 depending on experience and qualifications.
• Opportunity to work on cutting-edge healthcare technology and AI-driven product innovation.
• Collaborative and inclusive culture focused on diversity, growth, and employee impact.
• Leadership opportunities with visibility across executive teams and major healthcare clients.
• Flexible work environment supporting remote collaboration across multiple time zones.
• Professional development, mentorship, and career advancement opportunities.
• Exposure to innovative healthcare interoperability and digital transformation initiatives.
• Travel opportunities for client workshops, strategic sessions, and internal collaboration.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1