Product Owner (Risk Adjustment / EDPS)

Position Summary:

As a Product Owner/Domain Consultant you will be responsible for leading the product development related to Medicare and Medicaid lines of businesses, in the functional areas of Encounter data processing and Risk Adjustment models. You will be working in a highly collaborative environment to implement product vision with a clear focus on regulatory, customer and end-user needs. As part of the product organization, you will work collaboratively with Architecture, Compliance, IT, and Legal to deliver technologies and processes that comply with federal and state regulations.

Responsibilities:

• Own the end-to-end product strategy from concept to production. Provide vision and direction to all stakeholders in the product organization.
• Responsible for development and implementation of new product ideas and enhancements around Encounter data processing, Risk adjustment and provider management
• Manage product backlog, requirement documentation, product features, user manual updates.
• Lead the planning of product release plans and set delivery expectations.
• Perform market research, identify current product gaps, develop enhancement strategies, and maintain product roadmap
• Develop marketing presentations, provide product demo to prospective customers, design and lead rapid prototype application development
• Serve as subject matter expert and mentor to team members, providing guidance regarding product development best practices, processes, and tools
• Lead the SMEs in analyzing regulatory changes by CMS and state and determine product impact and plan changes to the product accordingly
• Lead design discussions between offshore and onshore on product development and enhancements. Lead requirement gathering and walk thru sessions
• Identifying areas for improvement in team processes and contributing to solutions to other products in the platform.
• Assist and lead program management and implementation teams in developing resource planning and implementation efforts

Required skills

• 8+ years of experience within the US healthcare industry around Medicare and Medicaid lines of business
• Strong knowledge of product management. Demonstrate experience in product development and implementations
• Strong subject matter expertise in Encounter data processing, Risk adjustment methodologies, HCCs, Chart review data expertise and Claims processing areas
• Good understanding on 834, 837, 820 X12 data formats and standards.
• Experience with CMS Submission Process, EDI transactions and response file processing flow
• Familiarity with ETL, mapping tools like IBM WTX. HIPAA Compliance
• Knowledge of CMS Risk score and risk adjustment methodologies
• Good working knowledge of SQL
• Ability to develop demo materials and conduct product demonstrations
• Familiarity with wireframe and design and working with UI/UX design teams

Preferred skills

• Good understanding of Mainframe legacy applications and integration
• Working knowledge in DB2, PostgreSQL
• Good understanding of front-end technologies, including HTML5, CSS3, JavaScript, ReactJS prototyping
• Familiarity with data modeling, analytics and data mining methods

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