Professional Services Manager (HEDIS & Risk)

Professional Services Manager

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building. Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare's greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

As a Professional Services Manager, you serve as a client-facing partner within Inovalon's Professional Services team for the Payer Business Unit. You help health plan and risk-bearing customers apply Inovalon solutions and services to their Quality/HEDIS, CMS Stars, and Risk Adjustment goals by translating data, workflows, and operational needs into effective execution. In this role, you manage multiple customer engagements at once, guide clients through issue resolution and product usage, and work across internal teams to improve customer outcomes, adoption, retention, and expansion. This position is remote, with a hybrid schedule required for employees who live within 40 miles of Tampa, FL, Canonsburg, PA, or Bowie, MD.

What You'll Do

• Manage multiple concurrent customer engagements across Inovalon's payer product portfolio, balancing priorities, timelines, risks, and dependencies to drive successful outcomes.
• Serve as the primary client-facing point of contact for assigned Quality/HEDIS, CMS Stars, and Risk Adjustment activities, building trusted relationships and managing customer expectations.
• Translate customer goals, workflows, business needs, and data questions into effective use of Inovalon's Professional Services offerings and software solutions, including Converged Quality and Converged Analytics.
• Investigate customer questions related to healthcare data, coding, and outputs, and explain how data inputs, system logic, and workflows affect results.
• Coordinate with internal partners across sales, implementation, customer success, product, and other teams to resolve issues, remove blockers, and support customer adoption and growth.
• Develop and apply expertise in healthcare quality, risk adjustment, regulatory requirements, and payer data concepts to provide clear guidance, education, and best practices to customers.
• Prepare high-quality written documentation, presentations, and client communications tailored to technical and non-technical audiences.
• Identify opportunities to improve customer value, retention, and expansion by understanding evolving client needs and communicating actionable next steps.
• Participate in training, certification, and knowledge-sharing activities, including learning Inovalon products and shadowing customer calls as needed.

What You'll Need

• Minimum of 5 years of health plan Quality/HEDIS, CMS Stars, and/or Risk Adjustment program delivery experience.
• Bachelor's degree required, preferably in healthcare, information systems, computer science, statistics, analytics, or a related field of study, or equivalent combination of education and experience required.
• Experience working effectively with internal or external stakeholders, with strong communication, relationship-building, and issue-management skills; previous customer-facing experience preferred.
• Ability to understand customer goals, workflows, and needs in complex healthcare and regulatory environments and translate them into effective use of solutions and services, including clear recommendations and actionable next steps.
• Strong knowledge of healthcare data, including familiarity with healthcare billing, reimbursement, and related payer data concepts.
• Excellent written, verbal, and presentation skills, with the ability to explain complex healthcare, regulatory, product, operational, and data concepts to different audiences.
• Strong organizational, analytical, and problem-solving skills, with the ability to manage numerous priorities independently in a fast-paced environment with ambiguity.
• Demonstrated learning agility by building product, industry, and regulatory expertise quickly and applying new knowledge to improve customer outcomes.
• Demonstrated leadership through cross-functional collaboration, sound judgment, constructive influence, and effective partnership during customer engagements and internal decision-making.
• Demonstrated adaptability by adjusting priorities and approach quickly while staying focused on execution and customer impact.
• Demonstrated creative thinking by identifying practical ways to solve customer workflow, process, and data challenges.
• Demonstrated analytical skills by interpreting data, identifying root causes, and using evidence to guide actions and recommendations.
• Nice to have: previous experience in professional services or consulting, preferably supporting payer customers; previous experience with Inovalon solutions; Snowflake and/or SQL experience; knowledge of Microsoft Office tools, including Access, Excel, Word, and Outlook; experience working at a health plan or healthcare software vendor.

Our Shared Commitments

• Maintain compliance with Inovalon's policies, procedures and mission statement;
• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; and
• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of Employer.

Work Environment

• This is primarily a computer-based role performed in a remote, hybrid, or office environment. The role requires prolonged periods of computer use and frequent communication and interaction with others, either virtually and/or in person. The role may occasionally require transporting or moving work-related equipment weighing up to 10 pounds, such as a laptop and related materials. Some travel may be required, depending on the needs of the role. Reasonable accommodations may be provided to enable qualified individuals with disabilities to perform the essential functions of the position, consistent with applicable law.

This position is not eligible for immigration sponsorship (e.g. H-1B, TN, or E-3). Applicants must be authorized to work in the United States as a condition of employment. (This is only applicable for US-based positions)

If you don't meet every qualification listed but are excited about our mission and the work described, we encourage you to apply. Inovalon is most interested in finding the best candidate for the job, and you may be just the right person for this or other roles.

By embracing inclusion, we enhance our work environment and drive business success. Inovalon strives to provide equal opportunities to the communities where we operate and to our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.

Inovalon is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.