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.
About the Role
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.
A Day in the Life
- 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 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.
