Senior Product Owner – AI for Risk Adjustment Coding

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About the Role

expertise in healthcare technology, AI/NLP, and Risk Adjustment Coding

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 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

How to Apply?

sagar.raisinghani@advantmed.com

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