Product Manager, Risk Adjustment Solutions

Vatica Health

6h•$80,000 - $100,000

About The Position

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.

Requirements

5+ years Product Management experience
5+ years experience with Risk Adjustment or Population Health technology
Strong understanding of Medicare Advantage, ACA, or Medicaid risk programs
Familiarity with HCC models and coding workflows
Experience collaborating with engineering teams on healthcare platforms
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.
Understands 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 interest mediating any points of abrasion.
Situational Adaptability & Flexibility
Adapts approach in real time to respond to different situations.
Thinks quickly and readily adapts behavior in the moment.
High level of versatility.

Responsibilities

Risk Adjustment Product Ownership
Own development and management of core Risk Adjustment capabilities including:
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 prioritize 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

Benefits

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
Comprehensive Medical, Dental, and Vision insurance plans
Tax-free Dependent Care Account
Life insurance, short-term, and long-term disability
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