
Description:
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 (v24v28), 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 Advantmed:
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).
Our solutions leverage deep domain expertise and AI/NLP technology to drive improved coding accuracy, regulatory compliance, and financial performance.
What We Offer:
- Opportunity to shape cutting-edge healthcare AI products at scale.
- A collaborative environment that values experimentation and innovation.
- Access to SMEs, engineers, and coders who live the problem every day.
- Leadership pathways in Product and AI domains.
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