Senior Director, AI-Driven Risk & Quality for Payers

Innovaccer Inc.; Northern (KY); Hybrid; USD 180,000 - 260,000; Full time

Benefits offered by this job

Generous Paid Time Off

Best-in-Class Parental Leave

Recognition & Rewards

Comprehensive Insurance Coverage

Job summary

Innovaccer Inc. is seeking a Senior Director of Product Management – Risk & Quality to own strategy across Risk Adjustment, RADV/Audit, Quality, and Compliance products.

Lead an AI-first roadmap and ensure regulatory agility to differentiate in CMS/HHS landscapes for health plan partners. You will partner with senior leaders to shape the Payer product narrative, drive revenue targets, and guide a cross-functional team including Engineering, Data Science, and Clinical SMEs to deliver scalable

Qualifications

• Experience: 10+ years in Product Management or related technology leadership roles, with at least 5+ years of direct experience building and scaling Risk Adjustment, RADV/Audit, or Quality solutions for health plans/payers.
• Domain Mastery: Deep expertise in Risk Adjustment methodologies (CMS-HCC, RxHCC, HHS-HCC), coding workflows (ICD-10, MEAT criteria), retrospective chart reviews, prospective point-of-care nudges, and RADV audit prep.
• AI & Data Fluency: Proven track record of shipping AI/ML capabilities into healthcare workflows (e.g., NLP for unstructured clinical documentation, predictive suspecting models, generative summaries for coders).
• Enterprise Scale: Demonstrated success in shipping and embedding SaaS products within complex payer environments and multi-payer enterprise systems.
• People Leadership: Strong track record of hiring, mentoring, and scaling high-performing product management teams while fostering a culture of ownership and AI adoption.
• Communication & Influence: Exceptional memo-writing and executive presentation skills; comfortable discussing risk models with actuaries, NLP accuracy with data scientists, and ROI with CFOs.
• Education: Bachelor’s degree in Computer Science, Health Informatics, Business, or related quantitative field required; Master’s/Advanced degree preferred.

Responsibilities

• Own the multi-year product strategy for Risk Adjustment, RADV Audit Management, Risk Analytics, and integrated Quality/HEDIS products.
• Lead AI-native product roadmap leveraging NLP, LLMs, and automated chart retrieval/coding engines.
• Stay ahead of CMS, HHS, and state regulatory landscapes to ensure continuous product compliance and market differentiation.
• Partner with VP Payer, CPO, and Market President- Payer Growth to shape the overall Payer product narrative and co-own revenue targets for your products.
• Direct and develop product managers to unify risk analytics, suspecting, chart review, coding workflows, and audit trail tools into a single, seamless product experience.
• Enforce an AI-first development lifecycle—from discovery and automated feedback synthesis to generative prototyping and intelligent backlog management.
• Delivery & Quality: Partner closely with Engineering, Data Science, Clinical SMEs, and Platform teams to build scalably on Innovaccer's Healthcare Intelligence Cloud, maintaining a predictable release cadence.
• Impact & ROI Metrics: Establish strict outcome-based success metrics (e.g., chart review accuracy, suspecting yield rates, RADV audit mitigation rate, coding velocity) and track customer value realization.
• Executive SPOC: Build direct relationships with plan executives (CMOs, Chief Risk Officers, Actuarial Leads, VPs of Risk Adjustment) to understand operational pain points and serve as the product authority for strategic discussions and escalations.
• GTM Enablement & Revenue Co-Ownership: Collaborate with Sales, Pre-Sales, and Customer Success to refine sales pitches, participate in key customer pursuits, support upsell/cross-sell initiatives, and validate product-market fit.
• Industry Representation: Represent Innovaccer’s Risk Adjustment perspective in external forums, industry advisory boards, and regulatory consultations.

Skills

Product Management

Leadership

AI/ML in healthcare

Risk Adjustment domain

Payer/Health insurance

SaaS product delivery

Regulatory compliance

Executive communication

Education

Bachelor’s degree in Computer Science, Health Informatics, Business, or related quantitative field

Master’s/Advanced degree preferred

Job description

Innovaccer Inc. is seeking a Senior Director of Product Management – Risk & Quality to own strategy across Risk Adjustment, RADV/Audit, Quality, and Compliance products.

Lead an AI-first roadmap and ensure regulatory agility to differentiate in CMS/HHS landscapes for health plan partners. You will partner with senior leaders to shape the Payer product narrative, drive revenue targets, and guide a cross-functional team including Engineering, Data Science, and Clinical SMEs to deliver scalable