Senior Product Owner – AI for Risk Adjustment Coding
About the job
Job Title: Senior Product Owner – AI for Risk Adjustment Coding Department: Product Management Reports To: Sr. Director of Product Location: Ahmedabad (Hybrid) About the Role We are seeking a Senior Product Owner with deep expertise in healthcare technology, AI/NLP, and Risk Adjustment Coding. You will be the bridge between data science, engineering, operations, and compliance — owning the roadmap for cutting-edge, AI-powered coding tools that improve coding accuracy, increase coder efficiency, and drive measurable impact in Medicare and ACA Risk Adjustment programs. This is a high-impact role responsible for shaping intelligent automation in chart review, first-pass coding, and coder augmentation. Required Qualifications: • 6+ years of product experience, with 2+ years as a Senior PO or equivalent role. • Hands-on experience with AI/ML/NLP-based products, preferably within healthcare. • Strong understanding of Risk Adjustment Coding, ICD-10, CMS-HCC models (v24–v28), and chart review processes. • Proven ability to work with engineering, data science, QA, and Ops teams to deliver data-driven products. • Skilled in writing user stories, defining acceptance criteria, and managing Agile ceremonies. • Strong analytical, stakeholder communication, and prioritization skills. Preferred Qualifications: • Prior experience with AI in clinical documentation, NLP pipelines, or EHR integrations. • Familiarity with OCR, document classification, or longitudinal patient charting. • Experience with ADO (Azure DevOps), Jira, Tableau, or other PM tools. • Exposure to coding quality audits or client-facing coding delivery teams. Key Responsibilities: Product Ownership & Vision • Define and own the product backlog for AI/NLP-driven Risk Adjustment features (e.G., auto-coding, TAMPER extraction, HCC recommendations). • Partner with Product Leadership to shape and communicate the product roadmap, aligning with Elevate platform initiatives. • Translate business objectives, user needs, and compliance requirements into clear, prioritized Epics and User Stories. Cross-functional Leadership • Work closely with NLP/Data Science teams to define model requirements, performance thresholds, and iteration cycles. • Collaborate with Coding Operations to validate output and gather feedback on coder usability and performance. • Interface with clinical SMEs, compliance, and clients to ensure AI products are trustworthy, explainable, and audit-compliant. Delivery & Execution • Lead sprint planning, backlog grooming, and demos with Scrum teams. • Track and report on delivery progress and key success metrics such as: • Auto-coding rate • Model precision/recall • Coder productivity improvement • Audit acceptance rate • Balance delivery of short-term tactical features with longer-term technical investments. Domain & AI/NLP Expertise • Ensure features adhere to CMS-HCC guidelines (v28 and future updates). • Understand coding workflows, TAMPER framework, and documentation gaps. • Work with data science on handling noisy data, confidence thresholds, and model versioning. Success Metrics: • % increase in auto-coded charts and coder productivity • NLP model precision, recall, and accuracy thresholds • Time-to-release for AI/NLP product features • Sprint predictability and delivery adherence • Stakeholder satisfaction and field feedback integration rate.
About the company
We are a technology-driven healthcare solutions provider, focused on streamlining clinical and administrative workflows for both payers and providers. Our core offerings include: - Traditional & Digital Medical Record Retrieval - Risk Adjustment Coding (CMS-HCC, ACA) - HEDIS Abstraction - Suspect Analytics & Gap Closure - Provider-Side Concurrent Coding (Billing & Documentation) - Health Assessments (In-home, Virtual)
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