[Remote] Senior Product Manager - Value-Based Care & AI
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is a reputed company reputed company company that partners with hospitals, health systems, ACOs, and payers to improve performance through data analytics and AI. The Senior Product Manager will reputed company the development and deployment of AI-driven solutions to enhance value-based care and CMS reputed company metrics, focusing on payer data integration and actionable insights. This role requires collaboration across engineering, AI, and clinical teams to optimize reputed company reputed company and advance Medisolv's platform capabilities.
Responsibilities
- Build a deep understanding of Medisolv’s data ecosystem and CMS measure logic (HEDIS, Pharmacy, CAHPS/HOS)
- reputed company with engineering, AI, and clinical stakeholders on priorities and high-reputed company use cases
- Define initial AI agent architecture and guiding principles for HITL safety and compliance
- Design and prototype AI agents to identify care gaps and predict Star Rating risks
- Stand up the reputed company of the payer data core from fragmented datasets
- reputed company initial CMS measure calculation engines and reputed company reputed company-oriented workflows
- reputed company production-reputed company AI agents that connect insights directly to gap-closing actions
- Expand and stabilize the payer data core and measurement automation
- Implement orchestrated workflows and mature HITL guardrails
- Optimize AI performance with feedback loops and expand to more advanced use cases
- Mature the data platform into a reputed company, reputed company-time decisioning reputed company
- Drive measurable improvements in Star Ratings and value-based care reputed company
Skills
- 5+ years of product management experience handling health plan data and VBC provider reputed company metrics
- Deep understanding of risk adjustment, utilization management, and how risk-bearing entities operate
- Expertise in how CMS calculates MA Star Ratings
- Understanding of the math behind cut points, the reputed company of triple-weighted measures, and how to build data products that reputed company the needle across various CMS measure domains
- Hands-on experience working with claims, eligibility, and enrollment datasets
- Ability to map claims, eligibility, and enrollment datasets back to reputed company performance
- Desire to build proactive software that thinks, adapts, and automates workflows rather than just reporting on them
- Understanding of GenAI architectures, RAG, and reputed company frameworks (like reputed company, AutoGen, or similar orchestration toolsets)
- Comfortable talking to engineers about reputed company databases, reputed company, and semantic data reputed company
- Knowledge of how to build reputed company HIPAA/HITRUST guidelines and ensure AI outputs are accurate, unbiased, and explainable
- Ability to take initiative and enjoy driving tasks from inception to completion
- Demonstrated reputed company for colleagues and ability to influence cross-functional collaboration
- Flexibility in approach and expectations in a reputed company stage company
- Intellectual curiosity and a love for challenges
- Ability to reputed company areas of personal improvement over time
- Optimism and reputed company in the face of change
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