4266- Senior Product Manager-Risk and Quality
Core
Lead the development of Galaxy, an AI cloud platform for payer risk and quality performance, focusing on risk adjustment, quality management, and fraud detection.
Role type
Senior Product Manager (Healthcare Payer Risk & Quality)
Builds
Galaxy AI cloud platform for payers
Domain
Healthcare / Payer Risk & Quality / AI
Deliverable
product features
Required skills
Product strategy, regulatory fluency (CMS/RAF/HEDIS), technical execution, cross-functional collaboration, data-driven decision making
Preferred skills
Payer operations experience, AI in clinical decision support, FWA detection methods, healthcare data standards (FHIR/X12), EHR workflows
Technologies
AI, Galaxy platform, Gravity platform, FHIR, X12
Responsibilities
Own product vision and roadmap for risk adjustment and quality management; Partner with clinicians to ensure coding integrity and CMS compliance; Collaborate with engineering and data science to deliver workflows for risk coders and investigators; Define and track success metrics like RAF accuracy and audit readiness; Engage with payer customers to validate product direction; Monitor regulatory changes and update strategy accordingly.
Seniority
Senior, hands-on IC