Director, Risk Adjustment Products

HealthEdge

Director of Risk Adjustment Products managing strategy and execution for risk adjustment solutions. Collaborating internally and externally to create innovative, impactful risk adjustment solutions.

Posted 5/28/2026full-timeRemote • 🇺🇸 United StatesLead💰 $170,000 - $225,000 per yearWebsite

Tech Stack

Tools & technologies

AWSCloudJavaSpringSpring BootSpringBootSQL

About the role

Key responsibilities & impact

Lead the strategy, roadmap, and execution for the product portfolio focused on retrospective risk adjustment solutions.
Define multi-year plans aligned to customer outcomes, regulatory drivers, and market trends.
Identify and prioritize use cases that leverage AI/ML and real-time data signals.
Drive innovation leveraging interoperability standards (FHIR, HL7, APIs).
Balance innovation with compliance and clinical integrity across all product decisions.
Ensure products are clinically relevant, user-centric, and integrated with existing payer and provider workflows.
Set and track KPIs for each product line.

Requirements

What you’ll need

Bachelor’s degree in business or technical field required; Master’s degree preferred.
10+ years of Risk Adjustment product management experience required.
5+ years leadership experience required.
Experience with Risk Adjustment Products and developing risk adjustment strategies.
Understanding of risk adjustment methodologies, including HCCs, CRGs, and other models used by CMS.
Understanding of Medical Record Review, digital channels and interoperability.
Experience working in AWS cloud environment.
Awareness of Agile tools and methodologies.
Understanding of SQL, Core Java, Spring Boot, Web Services, XML, JSON, Middleware, and CI/CD pipeline philosophy.

Benefits

Comp & perks

Health insurance
401(k) matching
Flexible work arrangements
Professional development opportunities

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Risk Adjustment product managementrisk adjustment strategiesHCCsCRGsMedical Record ReviewSQLCore JavaSpring BootWeb ServicesCI/CD pipeline

Soft Skills

leadershipstrategic planninginnovationuser-centric designcomplianceclinical integritycommunicationprioritizationtracking KPIsinteroperability

Certifications

Bachelor’s degreeMaster’s degree