Senior Risk-Adjustment Product Manager, Interoperability

Cotiviti; United States; Remote; USD 103,000 - 128,000; Full time

Benefits offered by this job

Benefits package including medical, d\

401(k) matching

Paid holidays

Paid time off

Job summary

Cotiviti is seeking a Product Manager to lead strategy, design, and delivery for Medicare, Medicaid, and ACA RA programs. You will partner with cross-functional teams to improve risk score accuracy, data completeness, and workflow efficiency while ensuring CMS and state compliance.

A key focus is enabling interoperable data exchange across clinical and administrative systems. The role requires expertise in risk models, coding workflows, and interoperability standards to deliver products that

Qualifications

• Experience in healthcare product management and analytics.
• Knowledge of risk adjustment and interoperability frameworks.
• Understanding of CMS-HCC, HHS-HCC, and Medicaid RA models.

Responsibilities

• Partner with stakeholders to identify opportunities to improve risk score accuracy and data quality.
• Translate regulatory changes into actionable product requirements and roadmaps.
• Drive interoperable data exchange and scalable RA solutions across systems.
• Collaborate with engineering, clinical, and data teams on models, workflows, and tools.
• Define user stories and workflows; mentor teams and lead initiatives from concept to implementation.

Skills

Healthcare product mgmt

Risk adjustment

Interoperability

CMS-HCC knowledge

Leadership

Stakeholder mgmt

Education

Bachelor's degree in Health Sciences

Job description

Cotiviti is seeking a Product Manager to lead strategy, design, and delivery for Medicare, Medicaid, and ACA RA programs. You will partner with cross-functional teams to improve risk score accuracy, data completeness, and workflow efficiency while ensuring CMS and state compliance.

A key focus is enabling interoperable data exchange across clinical and administrative systems. The role requires expertise in risk models, coding workflows, and interoperability standards to deliver products that