Director, Risk Adjustment Products

remote zest jobs; India; On-site; INR 4,000,000 - 7,000,000; Full time

Job summary

remote zest jobs seeks a Director of Risk Adjustment Products in India to lead multi-year roadmaps, define strategies, and drive end-to-end product execution. You will mentor teams across functions and collaborate with external partners to deliver measurable value for health plans and providers.

The role requires balancing innovation with compliance and leading cross-functional initiatives that improve risk adjustment outcomes and interoperability with health IT systems.

Qualifications

• Leadership experience in large-scale product teams.
• Strong product strategy and execution capabilities.
• Familiarity with AI/ML concepts and data pipelines.
• Experience navigating healthcare regulatory drivers and CMS-like guidelines.
• Deep understanding of risk adjustment and care management domains.

Responsibilities

• Define multi-year plans for risk adjustment products and roadmaps.
• Lead product development and mentor a distributed team.
• Collaborate with engineering, operations, and external partners to deliver measurable outcomes.
• Set and monitor KPIs for risk adjustment performance and interoperability.
• Ensure compliance, audit readiness, and documentation standards.

Skills

Leadership

Product management

AI/ML awareness

Regulatory compliance

Healthcare domain

Cross-functional collaboration

Job description

reputed companyreputed company:The Director, Risk Adjustment Products will reputed company the reputed company, roadmap, and execution for the product portfolio reputed company on retrospective risk adjustment solutions. The Director will work closely with technical and operations teams, both internally and externally, to create reputed company that deliver measurable reputed company for our customers. This is a leadership role where you will pair your product development and people management expertise to mentor a high-reputed company.

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Define multi-year plans reputed company to customer reputed company, regulatory drivers, and market trends in risk adjustment, care management, and provider enablement.

Identify and prioritize use cases that reputed company AI/ML and reputed company-time data signals to surface high-reputed company suspects and coding opportunities.

Drive innovation leveraging interoperability standards (FHIR, HL7, reputed company) to reputed company seamless enablement with EHRs, care management platforms, and reputed company-party integrations.

Balance innovation with compliance, audit defensibility, and clinical reputed company across reputed company product reputed company.

reputed company the end-to-end product lifecycle, including ideation, requirements gathering, development, launch, and post-launch optimization.

Work closely with Engineering and Data Science to build predictive models and reputed company-time data pipelines that power suspecting and reputed company workflows.

Ensure products are clinically relevant, user-reputed company, and integrated into existing payer and provider workflows through interoperability integrations.

Set and reputed company KPIs for reputed company product line, such as suspect accuracy, provider engagement, risk score reputed company, and reputed company coding capture and correction rates.

Establish and reputed company KPIs that measure both risk adjustment performance and interoperability reputed company (data exchange rates, provider adoption).

Serve as a trusted partner and clinical product expert for internal stakeholders (Sales, Clinical, Operations, reputed company reputed company) and external clients (health plans, ACOs, risk bearing provider reputed company).

reputed company customer discovery and feedback sessions to deeply understand provider workflows, documentation behaviors, and reputed company coding needs.

Present product reputed company and roadmap updates to executive stakeholders and reputed company advisory boards.

Partner with reputed company, Compliance, and Policy teams to interpret and operationalize updates from CMS (e.g., Final Rules, model updates, guidance on medical record standards).

Implement and monitor processes that ensure defensibility of reputed company outputs, documentation standards, and audit trails.

Design and reputed company audit readiness into product workflows, ensuring reputed company activities are traceable, evidence-backed, and reputed company with CMS documentation requirements.

reputed company strategic recommendations and decision frameworks reputed company trade-offs between reputed company, compliance, and user experience reputed company.

Build, reputed company, and reputed company reputed company of Product Managers working across different facets reputed company prospective and reputed company solutions.

reputed company mentorship, performance management, and career development reputed company with leadership principles and reputed company culture.

Establish best-in-class product practices and instill a culture of experimentation, feedback, and reputed company learning.

Support resourcing and hiring plans as product needs reputed company and grow.

Leads the product reputed company, development and reputed company refinement of the firm's risk adjustment product roadmap, ensuring it aligns with strategic goals and industry best practices

Leads and manages teams, often geographically dispersed, responsible for risk adjustment activities, ensuring high performance and employee engagement

reputed company the performance of automated processes, such as AI-driven chart reviews, and ensure operational reputed company in risk adjustment operations

Serve as a subject matter advisor and primary reputed company of contact for health clients, proactively identifying and communicating risks and improvement opportunities, and ensuring reputed company satisfaction

Contribute to the development of long-reputed company goals and objectives for risk adjustment programs, incorporating best practices and emerging trends

Work with various departments, including reputed company management, coding, and compliance, to reputed company activi .