Product Manager

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $103k - $128k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

✅ Product Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Lead the strategy, design, and delivery of solutions for Medicare, Medicaid, and ACA Risk Adjustment programs • Partner with enterprise and customer stakeholders to improve risk score accuracy, data completeness, and workflow efficiency • Define risk adjustment product use cases and validate them through workflow analysis and VOC sessions • Translate CMS, HHS, and state regulatory changes into product requirements and roadmap updates • Drive interoperability-focused product design supporting EHR/EMR and clinical data exchange • Collaborate with engineering, clinical, and data teams to design scalable risk adjustment solutions, including suspecting models, chart review workflows, coding tools, clinical ingestion pipelines, and other modules • Evaluate risk adjustment use cases for AI/ML, automation, and workflow optimization opportunities • Own the voice of the customer by gathering feedback to drive adoption and continuous improvement • Build ROI models and product business cases for new features, analytics, and interoperability enhancements • Guide analytics teams on exploratory risk adjustment analysis and operationalize findings into scalable product capabilities • Ensure risk adjustment solutions support interoperability compliance • Support implementations and program year transitions, ensuring configuration changes are successfully deployed • Contribute to long-term product strategy focused on scalability, interoperability, automation, and regulatory readiness • Complete annual performance review and/or goal-setting responsibilities • Complete special projects and other assigned duties • Guide teams and represent Cotiviti's interoperability expertise internally and externally • Mentor others and lead without authority when required

🎯 Requirements

• Bachelor's degree with strong academic performance in Health Sciences, Computer Science, Engineering, Economics, Mathematics, or another quantitative field • 3+ years of experience in healthcare product management, analytics, consulting, or technology, including 2+ years developing risk adjustment products • Demonstrated knowledge of risk adjustment and interoperability frameworks • Knowledge of CMS-HCC, HHS-HCC, and Medicaid Risk Adjustment models • Understanding of EHR/EMR data and clinical interoperability • Understanding of clinical documentation, coding workflows, and provider specialty taxonomy • Understanding of prospective and retrospective RA programs • Experience working with cross-functional, matrixed product teams in an agile environment • Experience defining customer workflows and user stories • Excellent communication and stakeholder management abilities • Ability to translate regulatory/clinical requirements into technical solutions and explain technical concepts to non-technical audiences • Strong problem-solving mindset and track record of driving initiatives from concept to implementation • Leadership and mentorship capabilities • Must be able to provide a dedicated, secure work area • Must be able to provide high-speed internet access/connectivity and office setup and maintenance • Must be able to perform duties with or without reasonable accommodation

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance coverage • 401(k) savings plans • Paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti • Dedicated, secure work area • High-speed internet access/connectivity and office setup and maintenance