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Job Description

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 situations.

+ Ability to interact politely, tactfully and firmly with a wide range of people and personalities.

+ Ability to work in an environment with potential interruptions.

+ Ability to manage multiple simultaneous tasks with individual timeframes and priorities.

The expected base salary for this position ranges from $120,000.00 – 135,000.00 USD with a bonus target of up to 10% of the base salary. While it is not typical to offer candidates at or near the top of the range, we do consider a wide range of factors when making offer decisions, including (but not limited to) the scope and responsibilities of the position, a candidate’s relevant skills, training, experience, education and where applicable, licensure and certifications obtained. We also consider organizational and market factors when making offer decisions. This range is a general guideline and represents a good faith estimate of what we would reasonably expect to pay for this position. We reserve the right to modify this range in the future as organizational and market conditions dictate.

At Convey, we believe that the right benefits package can improve the quality of our employees and their family members’ lives. Therefore, we offer a competitive total rewards package, which includes health and welfare benefits, 401(K) savings with employer matching, paid time off, life, AD&D and disability insurances, and various ancillary benefits, such as pet insurance, virtual physical therapy, and employee assistance programs.

Equal Employment Opportunity Statement

Convey Health Solutions is an Equal Opportunity Employer committed to fostering an inclusive and diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other characteristic protected by applicable federal, state, or local laws.

Convey Health Solutions also provides reasonable accommodations to qualified individuals with disabilities in accordance with applicable laws. Applicants requiring accommodation during the application or interview process should contact the Human Resources department.

About Us

About UsConvey Health Solutions, together with Pareto Intelligence™, delivers a powerful combination of purpose-built technology, advanced analytics, and expert services to help health plans thrive in a complex, post--Affordable Care Act environment.As a trusted partner to Medicare and commercial payers, we provide scalable, compliant solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment, Stars performance, and member engagement. Pareto's deep analytics and financial intelligence complement Convey's operational expertise, enabling our clients to improve performance, reduce costs, and create better healthcare experiences for millions of Americans--especially seniors and vulnerable populations.Together, we help health plans scale smarter, grow stronger, and make healthcare work better for the people who need it most. Learn more at http://www.ConveyHealthSolutions.com