Sr. Product Manager

 

About the job

Pareto Intelligence, a Convey Health Solutions company seeks a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical role, you will drive the strategic planning, development, and optimization of our Medicare Advantage Risk Adjustment solution, ensuring that our deliverables support the marketplace with analytics to drive risk score accuracy and actionability. The ideal candidate will work closely with cross-functional teams, including Client Advisory, Engineering & Operations, and Data Science/Analytics, to deliver scalable solutions that enhance our Medicare Advantage offering. This position reports to the Vice President, Risk Solutions.

 

KEY DUTIES AND RESPONSIBILITIES:

 

• Lead Product Strategy: Define and execute the roadmap for the Medicare Advantage Risk Adjustment solution, ensuring alignment with company goals and regulatory requirements.
• Cross-Functional Collaboration: Work closely with various teams ideate, prototype, operationalize, and implement new features aimed at supporting both internal and external analytic needs.
• Data-Driven Decision Making: Utilize data to monitor performance, identify opportunities for improvement, and lead efforts to enhance accuracy and efficiency in the risk adjustment process.
• Regulatory Compliance: Ensure all products, processes, and activities comply with CMS (Centers for Medicare & Medicaid Services) regulations, as well as other federal and state health insurance regulations, where applicable
• Market Research / Trends: Establish a network of internal / external constituents to understand market dynamics and expectations to support solution analytics
• Continuous Improvement: Lead initiatives to continually improve the innovation & development processes for rapid release of new features into the market by leveraging emerging technologies, industry best practices, and feedback from stakeholders.
• Monitoring and Reporting: Track key performance indicators (KPIs) and deliver regular updates to leadership regarding the success and challenges solution enhancements & evolution.
• Stakeholder Management: Serve as a key point of contact for internal and external stakeholders, managing expectations and ensuring alignment on solution direction and initiatives.

 

 

EDUCATION AND EXPERIENCE:

 

 

• Bachelor’s degree or equivalent experience in a related field (e.g., Business, Healthcare Administration, Public Health. A master’s degree or relevant certifications (e.g., PMP, Lean Six Sigma) is a plus.
• Minimum of 5+ years of experience in healthcare product management, with at least 3+ years in Medicare Advantage Risk Adjustment or a related field.
• Strong understanding of Medicare Advantage programs, risk adjustment models (e.g., HCC coding), and the regulatory environment (CMS).
• Experience working on cross functional software development teams.
• Proficient in Jira, Confluence, and Amplitude.

 

 

PREFERRED SKILLS AND EXPERIENCE:

 

• Proven track record of managing complex, data-driven product initiatives from ideation through execution.
• Experience in the Medicare Advantage risk adjustment marketplace.
• Ability to influence and collaborate with cross-functional teams and external partners.

 

 

OTHER DUTIES AND RESPONSIBILITIES:

 

• Responsible for compliance with all federal, state and local laws, rules and regulations affecting Company.
• Responsible for participating in quality assurance, compliance and in-service and continuing education activities as requested by Company.
• Responsible for performing other duties and responsibilities as required.

 

 

Knowledge, Skills, and Abilities:

 

• Excellent written, verbal and interpersonal communication skills.
• Excellent organizational skills and attention to detail.
• Excellent documentation skills.
• Team player.
• Excellent management skills.
• Ability to provide clear and accurate information through multiple media.
• Ability to manage open requests and follow up, when necessary, without outside direction.
• Ability to write routine reports and correspondence.
• Ability to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized si