Product Manager, Risk Adjustment Solutions

We are seeking a Product Manager to lead Risk Adjustment product capabilities across all lines of business, including Medicare Advantage, ACA Marketplace, and Medicaid.

This role owns the execution and evolution of Risk Adjustment solutions within our population health platform, ensuring accurate risk capture, compliant submissions, and efficient coding workflows for health plans and provider organizations.

The Product Manager will work closely with engineering, clinical coding teams, operations, and customer success teams, while collaborating with the Head of Platform on overall product strategy and roadmap direction.

Responsibilities
Risk Adjustment Product Ownership

HCC model updates and configuration

Risk score computation across supported models

Suspect generation and accuracy management

Encounter data reconciliation

Risk adjustment reporting and analytics

Ensure platform support for

Medicare Advantage (CMS-HCC)

ACA Marketplace (HHS-HCC)

Medicaid risk adjustment models

Regulatory & Program Monitoring

Track CMS announcements and regulatory updates

Ensure timely platform updates aligned with HCC model changes

Monitor LOB-specific submission timelines and program requirements

Work closely with clinical coding teams and outbound operations teams to support operational readiness

Product Development & Enhancements

Identify and define new feature enhancements

Design product workflows and requirements

Maintain and prioritise product backlog

Work with engineering teams and TPMs to track development progress

Validate completed features prior to release

Client & Customer Success Collaboration

Work closely with Customer Success teams to understand client workflows and challenges

Participate in client discussions when needed

Translate client feedback into product improvements and roadmap priorities

Product Strategy Collaboration

Work in close collaboration with the Head of Platform to align Risk Adjustment capabilities with overall platform strategy

Provide domain expertise and product insights to inform roadmap planning

5+ years Product Management experience

5+ years experience with Risk Adjustment or Population Health technology

Strong understanding of Medicare Advantage, ACA, or Medicaid risk programmes

Familiarity with HCC models and coding workflows

Experience collaborating with engineering teams on healthcare platforms

Competencies
Communicates Effectively

Exchanging ideas, knowledge, and data so that the message is received and understood with clarity and purpose.

Leverages emotional intelligence to adapt to the emotions and intentions of others.

Plans and Aligns, Resourcefulness

Plans and prioritizes work to meet the goals of the business.

Breaks down objectives into plans and actions to achieve significant milestones.

Anticipates and readily adjusts plans.

Maintains organization of resources to support efficiency.

Business Insight & Organizational Savvy

Ensures work and tasks are aligned to meet company priorities.

Breaks down goals into actions with milestones.

Understand how to navigate the company and connect with key stakeholders or contributors.

Collaborates

Identifies and builds partnerships to meet shared goals.

Readily partners with others to meet objectives and shares credit for contributions.

Demonstrates cooperation that earns support of others.

Balances Stakeholders & Manages Conflict

Anticipating and balancing the needs of multiple stakeholders and multiple projects.

Highly prepared and knowledgeable about expectations.

Delivers fair and flexible response to stakeholder needs.

Handling conflict situations to resolution effectively and professionally.

Applies fair decision-making to balance competing interests mediating any points of abrasion.

Situational Adaptability & Flexibility

Adapts approach in real time to respond to different situations.

Think quickly and readily adapts behavior in the moment.

High level of versatility.

Working at Vatica Health Advantages
Prosperity

Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar

Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded

401k plans– we want to empower you to prepare for your future

Room for growth and advancement- we love our employees and want to develop within

Good Health

Comprehensive Medical, Dental, and Vision insurance plans

Tax‑free Dependent Care Account

Life insurance, short‑term, and long‑term disability

Happiness

Excellent PTO policy (everyone deserves a vacation now and then)

Great work‑life balance environment- We believe family comes first!

Strong supportive teams- There is always a helping hand when you need it

The salary for a position is typically determined by multiple factors such as the individuals qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $80,000 to $100,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered.

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