Hueman Risk Adjustment Solutions Jobs in Kentucky

MedeAnalytics is the Enterprise Healthcare Performance company that delivers AI-driven, cloud-native solutions to help payers, risk-bearing providers and other value- and risk-bearing entities measurably improve performance by reducing costs, improving quality and MLR, optimizing utilization, increasing reimbursement, and elevating care quality across all lines of business. Its enterprise health data management platform—built on its proprietary Health Fabric™—unifies clinical, claims, financial, and social data into a single, scalable source of truth that fuels insights, action, and AI.

As the industry’s healthcare intelligence partner of choice for more than 30 years, MedeAnalytics combines its platform, cross-domain enterprise analytics, AI-powered workflows, and Strategic Advisory™ services to transform intelligence into accountable execution—delivering greater ROI across value-based care, risk and quality, cost and utilization management, and network optimization.

MedeAnalytics empowers organizations to move faster from insight to impact with confidence and measurable results. To learn more, visitmedeanalytics.com and follow MedeAnalytics onLinkedIn andFacebook .

About Our Opportunity

MedeAnalytics is seeking aDirector, Product Management to lead the design, development, commercialization, and lifecycle management of analytical and automation products. Operating at the direction of the Sr. VP, Commercial Product, this leader will own a segment of MedeAnalytics payer product portfolio serving health plans across commercial/employer, Medicaid managed care/HMO, Medicare Advantage, and Dual Eligible/D-SNP segments.

This role is designed for a senior product leader with deep payer domain expertise and a proven track record designing, developing, and commercially launching healthcare analytics and automation products. The director will translate market needs, customer insights, regulatory requirements, and company strategy into differentiated product capabilities that improve health plan performance, risk and quality outcomes, cost management, operational efficiency, and measurable customer value.

The successful candidate will combine market-facing product activities with disciplined product lifecycle management to drive execution of commercial strategies while driving customer engagement. Additionally, the Director will function as a strong cross-functional orchestrator by partnering closely with Engineering, AI & Data Science, IT, Customer Success, Sales & Consulting, Marketing, Implementation, Finance, and Executive Leadership to bring new high-value payer products from concept to adoption, revenue, and scale.

• Own the product vision, strategy, roadmap, and investment priorities for an assigned portfolio of payer analytics and workflow solutions.
• Maintain a strong understanding of target payer segments, customer needs, market dynamics, competitive offerings, and regulatory considerations.
• Identify and prioritize unmet payer needs across areas such as risk adjustment, quality improvement, HEDIS and Stars performance, population health, cost and utilization management, provider and network performance, care management, and operational automation.
• Translate customer, market, competitive, regulatory, and business insights into product priorities, business cases, and differentiated product capabilities.
• Develop recommendations regarding market opportunities, customer segments, product positioning, packaging, pricing inputs, and portfolio tradeoffs.
• Communicate product strategy, roadmap direction, investment priorities, and product performance to executive leaders, customers, and cross-functional teams.

• Lead the full product lifecycle for the assigned portfolio, including discovery, validation, development, launch, adoption, optimization, and retirement.
• Ensure product teams translate payer business problems into clear use cases, product requirements, user journeys, workflows, data needs, and measurable success criteria.
• Partner with Engineering, Data Science, Architecture, Design, Security, and Compliance to deliver scalable, secure, configurable, and enterprise-ready SaaS solutions.
• Guide customer discovery, product validation, prototyping, pilot programs, beta programs, and feedback processes.
• Maintain effective roadmap, prioritization, release-readiness, and portfolio-review processes for the assigned product area.
• Partner with Product Marketing, Sales, Customer Success, Implementation, Support, and Enablement to prepare products for launch and adoption.
• Establish and monitor product performance measures, including adoption, customer value, retention, revenue contribution, margin, implementation effort, support trends, and customer outcomes.
• Use product, customer, and financial data to recommend continued investment, acceleration, repositioning, consolidation, or retirement of products.
• Guide the development of analytics and workflow solutions that support payer priorities such as value-based care, risk adjustment, quality improvement, cost and utilization management, provider performance, care-gap closure, and operational efficiency.
• Ensure products reflect payer workflows, economics, data requirements, regulatory obligations, and implementation realities.
• Incorporate actionable analytics, predictive capabilities, and workflow automation that help customers move from insight to intervention and measurable outcomes.
• Partner with clinical, actuarial, quality, risk, network, medical economics, regulatory, and operations stakeholders to inform product decisions.
• Maintain deep expertise in the primary payer segments served by the assigned portfolio and sufficient knowledge of adjacent segments to support shared capabilities and market expansion.

• Establish ongoing voice-of-customer and market-discovery practices with payer customers, prospects, partners, and internal customer-facing teams.
• Partner with Product Marketing and Sales to define target segments, buyer personas, value propositions, competitive differentiation, sales narratives, demonstrations, and launch plans.
• Support strategic sales opportunities, renewals, and executive customer discussions by clearly articulating product strategy, roadmap direction, and expected business outcomes.
• Partner with Customer Success and Implementation to improve onboarding, configuration, adoption, value realization, and customer referenceability.
• Monitor relevant payer market, reimbursement, regulatory, data, analytics, artificial intelligence, interoperability, and workflow-automation trends.

• Create consistent product-management practices across the team while allowing appropriate flexibility based on product maturity and customer needs.
• Build alignment across technical, commercial, clinical, operational, and customer-facing teams and resolve product-priority and resource tradeoffs.
• Promote a customer-focused, data-informed, and outcome-oriented product culture.

• 8+ years of product management experience in healthcare technology, payer analytics, enterprise SaaS, or a closely related environment.
• 3+ years of experience managing product managers or leading multiple complex product workstreams and cross-functional product teams.
• Strong payer or health-plan domain experience, with deep expertise in at least one of the following areas: commercial or employer-sponsored health plans, Medicare Advantage, Medicaid managed care, or dual-eligible and D-SNP programs.
• Demonstrated experience developing and launching payer-facing products from concept through market introduction, adoption, and measurable customer or commercial outcomes.
• Strong experience in several payer capability areas, such as value-based care, risk adjustment, quality improvement, HEDIS or Stars, population health, cost and utilization analytics, care management, network performance, or provider performance.
• Experience managing product roadmaps, prioritization processes, business cases, launch readiness, and product performance measurement.
• Working knowledge of healthcare data and analytics, including claims, eligibility, encounters, clinical data, pharmacy data, provider data, member data, interoperability, data quality, dashboards, predictive analytics, and workflow automation.
• Strong business and commercial judgment, including experience with market assessment, product economics, pricing and packaging inputs, sales enablement, and product performance metrics.
• Demonstrated ability to lead through influence and make decisions in a complex, matrixed organization.
• Strong executive communication skills, with the ability to translate complex payer, product, data, and technology topics into clear recommendations and decisions.

• Direct experience with one or more of the following: commercial plan management, Medicare Advantage Stars, HEDIS and NCQA quality programs, CMS or ACA risk adjustment, HCC and RAF analytics, Medicaid quality programs, value-based care contracts, alternative payment models, or D-SNP operations.
• Experience developing AI- or machine-learning-enabled analytics, predictive solutions, workflow automation, embedded analytics, care-gap solutions, provider performance solutions, or interoperability capabilities.
• Experience working with payer executives and operational leaders across q