4266- Senior Product Manager-Risk and Quality

We are seeking a Senior Product Manager to lead the development of our Galaxy, Innovaccer's AI cloud for payer risk and quality performance. In this role, you will shape products across risk adjustment, quality management (Stars/HEDIS), and Fraud, Waste, and Abuse (FWA) — helping payers capture risk accurately, close care and quality gaps faster, and maintain year-round audit readiness on a single, unified data model.Galaxy consolidates fragmented point solutions into one data foundation, eliminating the performance blind spots created by 6–12 disconnected tools. You will own products that coordinate gap closure across channels, apply AI to chart retrieval and coding, strengthen program integrity through FWA detection, and keep clinical, claims, and utilization data unified on the Gravity platform.You will work closely with clinicians, quality and risk adjustment experts, data scientists, engineers, and analytics teams to design and deliver solutions aligned with CMS rules, evidence-based guidelines, and payer operating realities. Given the India base, this role requires strong asynchronous collaboration with US-based stakeholders and customers. This role demands a blend of product strategy, regulatory fluency, technical execution, and deep empathy for the payer teams navigating Stars, RAF accuracy, and program integrity simultaneously.Product Management at Innovaccer Our product team is a collaborative group of talented professionals who transform ideas into real-life solutions. They guide the creation, development, and launch of new products, ensuring alignment with our overall business strategy. Additionally, we are leveraging AI across all our solutions, revolutionizing healthcare and shaping the future to make a meaningful impact on the world.Requirements● Own the product vision, strategy, and roadmap for Galaxy across risk adjustment, quality management, and Fraud, Waste, and Abuse.● Partner with clinicians and subject matter experts to ensure clinical accuracy, coding integrity, and CMS compliance.● Collaborate with engineering, data science, and design to deliver intuitive workflows for risk coders, quality analysts, SIU/FWA investigators, and medical management staff.● Define success metrics (e.g., RAF capture accuracy, care/quality gap closure rates, Stars performance, FWA detection precision and recoveries, audit readiness) and track product performance.● Engage directly with payer customers (MA plans, Medicaid managed care, regional plans) to gather feedback and validate product direction, accommodating US time zones as needed.● Monitor regulatory and industry changes — V28, RADV audit requirements, HEDIS measure updates, CMS interoperability rules — and update product strategy accordingly.● Work cross-functionally with sales, marketing, and implementation teams to drive adoption and market growth.● Serve as an internal expert on payer risk and quality workflows, FWA program integrity, and the regulatory landscape. What You'll Need● 5–8+ years of product management experience, ideally in healthcare technology, based in India.● xperience in payer operations, risk adjustment, quality (Stars/HEDIS), utilization management, or Fraud, Waste, and Abuse strongly preferred.● Demonstrated experience working with AI technologies in product development, ideally in clinical decision support, coding automation, anomaly detection, or data-driven products.● Strong understanding of CMS programs and regulatory frameworks — RAF/HCC, V28, RADV, HEDIS, and prior authorization interoperability standards.● Excellent communication skills, with the ability to collaborate across clinical, technical, and business teams, and across geographies and time zones.● Comfort with ambiguity and a fast-paced environment; able to balance long-term vision with near-term execution.● Familiarity with FWA detection methods, SIU workflows, or claims integrity analytics is a strong plus.● Familiarity with healthcare data standards (FHIR, X12) and payer data ecosystems.● Experience working with payer platforms, chart retrieval/abstraction, or quality reporting systems.● Experience working with EHR systems and provider workflows.We offer competitive benefits to set you up for success in and outside of work. BenefitsHere's What We Offer • Generous Leave Benefits: Enjoy generous leave benefits of up to 40 days. • Parental Leave: Experience one of the industry's best parental leave policies to spend time with your new addition. • Sabbatical Leave Policy: Want to focus on skill development, pursue an academic career, or just take a break? We've got you covered. • Health Insurance: We offer health benefits and insurance to you and your family for medically related expenses related to illness, disease, or injury. • Pet-Friendly Office*: Spend more time with your treasured friends, even when you're away from home. Bring your furry friends to the office. *Noida office only • Creche Facility for children*: A convenient and reliable creche facility that puts your child's well-being first. *India offices Where and how we work Our Noida office is situated in a posh techspace, equipped with various amenities to support our work environment. Here, we follow a five-day work schedule, allowing us to efficiently carry out our tasks and collaborate effectively within our team. Innovaccer is an equal-opportunity employer. We celebrate diversity, and we are committed to fostering an inclusive and diverse workplace where all employees, regardless of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, marital status, or veteran status, feel valued and empowered. Disclaimer: Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at px@innovaccer.com. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details. About Innovaccer Innovaccer Inc. is the data platform that accelerates innovation. The Innovaccer platform unifies patient data across systems and care settings, and empowers healthcare organizations with scalable, modern applications that improve clinical, financial, operational, and experiential outcomes. Innovaccer’s EHR-agnostic solutions have been deployed across more than 1,600 hospitals and clinics in the US, enabling care delivery transformation for more than 96,000 clinicians, and helping providers work collaboratively with payers and life sciences companies. Innovaccer has helped its customers unify health records for more than 54 million people and generate over $1.5 billion in cumulative cost savings. The Innovaccer platform is the #1 rated Best-in-KLAS data and analytics platform by KLAS, and the #1 rated population health technology platform by Black Book. For more information, please visit innovaccer.com. Check us out on YouTube, Glassdoor, LinkedIn, and innovaccer.com.

We are seeking a Senior Product Manager to lead the development of our Galaxy, Innovaccer's AI cloud for payer risk and quality performance. In this role, you will shape products across risk adjustment, quality management (Stars/HEDIS), and Fraud, Waste, and Abuse (FWA) — helping payers capture risk accurately, close care and quality gaps faster, and maintain year-round audit readiness on a single, unified data model.

Galaxy consolidates fragmented point solutions into one data foundation, eliminating the performance blind spots created by 6–12 disconnected tools. You will own products that coordinate gap closure across channels, apply AI to chart retrieval and coding, strengthen program integrity through FWA detection, and keep clinical, claims, and utilization data unified on the Gravity platform.

You will work closely with clinicians, quality and risk adjustment experts, data scientists, engineers, and analytics teams to design and deliver solutions aligned with CMS rules, evidence-based guidelines, and payer operating realities. Given the India base, this role requires strong asynchronous collaboration with US-based stakeholders and customers. This role demands a blend of product strategy, regulatory fluency, technical execution, and deep empathy for the payer teams navigating Stars, RAF accuracy, and program integrity simultaneously.

Product Management at Innovaccer

Our product team is a collaborative group of talented professionals who transform ideas into real-life solutions. They guide the creation, development, and launch of new products, ensuring alignment with our overall business strategy. Additionally, we are leveraging AI across all our solutions, revolutionizing healthcare and shaping the future to make a meaningful impact on the world.

Requirements

● Own the product vision, strategy, and roadmap for Galaxy across risk adjustment, quality management, and Fraud, Waste, and Abuse.

● Partner with clinicians and subject matter experts to ensure clinical accuracy, coding integrity, and CMS compliance.

● Collaborate with engineering, data science, and design to deliver intuitive workflows for risk coders, quality analysts, SIU/FWA investigators, and medical management staff.

● Define success metrics (e.g., RAF capture accuracy, care/quality gap closure rates, Stars performance, FWA detection precision and recoveries, audit readiness) and track product performance.

● Engage directly with payer customers (MA plans, Medicaid managed care, regional plans) to gather feedback and validate product direction, accommodating US time zones as needed.

● Monitor regulatory and industry changes — V28, RADV audit requirements, HEDIS measure updates, CMS interoperability rules — and update product strategy accordingly.

● Work cross-functionally with sales, marketing, and implementation teams to drive adoption and market growth.

● Serve as an internal expert on payer risk and quality workflows, FWA program integrity, and the regulatory landscape.

What You'll Need

● 5–8+ years of product management experience, ideally in healthcare technology, based in India.

● xperience in payer operations, risk adjustment, quality (Stars/HEDIS), utilization management, or Fraud, Waste, and Abuse strongly preferred.

● Demonstrated experience working with AI technologies in product development, ideally in clinical decision support, coding automation, anomaly detection, or data-driven products.

● Strong understanding of CMS programs and regulatory frameworks — RAF/HCC, V28, RADV, HEDIS, and prior authorization interoperability standards.

● Excellent communication skills, with the ability to collaborate across clinical, technical, and business teams, and across geographies and time zones.

● Comfort with ambiguity and a fast-paced environment; able to balance long-term vision with near-term execution.

● Familiarity with FWA detection methods, SIU workflows, or claims integrity analytics is a strong plus.

● Familiarity with healthcare data standards (FHIR, X12) and payer data ecosystems.

● Experience working with payer platforms, chart retrieval/abstraction, or quality reporting systems.

● Experience working with EHR systems and provider workflows.

We offer competitive benefits to set you up for success in and outside of work.

Benefits

Here's What We Offer

• Generous Leave Benefits: Enjoy generous leave benefits of up to 40 days.

• Parental Leave: Experience one of the industry's best parental leave policies to spend time with your new addition.

• Sabbatical Leave Policy: Want to focus on skill development, pursue an academic career, or just take a break? We've got you covered.

• Health Insurance: We offer health benefits and insurance to you and your family for medically related expenses related to illness, disease, or injury.

• Pet-Friendly Office*: Spend more time with your treasured friends, even when you're away from home. Bring your furry friends to the office. *Noida office only

• Creche Facility for children*: A convenient and reliable creche facility that puts your child's well-being first. *India offices

Where and how we work

Our Noida office is situated in a posh techspace, equipped with various amenities to support our work environment. Here, we follow a five-day work schedule, allowing us to efficiently carry out our tasks and collaborate effectively within our team.

Innovaccer is an equal-opportunity employer. We celebrate diversity, and we are committed to fostering an inclusive and diverse workplace where all employees, regardless of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, marital status, or veteran status, feel valued and empowered.

Disclaimer: Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR

department at px@innovaccer.com. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.

About Innovaccer

Innovaccer Inc. is the data platform that accelerates innovation. The Innovaccer platform unifies patient data across systems and care settings, and empowers healthcare organizations with scalable, modern applications that improve clinical, financial, operational, and experiential outcomes. Innovaccer’s EHR-agnostic solutions have been deployed across more than 1,600

hospitals and clinics in the US, enabling care delivery transformation for more than 96,000 clinicians, and helping providers work collaboratively with payers and life sciences companies.

Innovaccer has helped its customers unify health records for more than 54 million people and generate over $1.5 billion in cumulative cost savings. The Innovaccer platform is the #1 rated Best-in-KLAS data and analytics platform by KLAS, and the #1 rated population health technology platform by Black Book. For more information, please visit innovaccer.com.

Check us out on YouTube, Glassdoor, LinkedIn, and innovaccer.com.