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Opportunity Description
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Senior Product Manager, Risk Adjustment
CA - Irvine

Opportunity Snapshot

This key position, managing an important product for our company, will call on your deep understanding of Risk Assessment and experience as a product manager, giving you many opportunities to shine in a fast-paced environment. Quick question for you - click here  As the Senior Product Manager for Risk Adjustment, you’ll take over management of current RA products, but that’s just the beginning. You’ll help build and shape the exciting new modules and extensions that we are considering.

You’ll also call on your skill as a subject matter expert and expand your knowledge to an even broader view of risk assessment in health care. You’ll have the chance to consider best practices for RA and distil, communicate, share, and represent those best practices to the industry through seminars and presentations.

Dynamic Healthcare Systems, Inc. delivers comprehensive solutions for Medicare Advantage health plans striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to companies serving the Medicare population.

Pictured: We offer the complete solution for your Medicare Advantage needs.

The Requirements

To be a good fit for this opportunity you will have:
  • A bachelor’s degree in a related field.
  • 5+ years of experience working for a health plan, managing a risk adjustment program where you optimized scores and trained internal stakeholders and providers on risk adjustment.
  • A deep understanding of and knowledge in the HCC and RxHCC Risk Adjustment models. Quick question for you - click here
  • 2+ years of experience as a product manager or in software design, with the ability to write business requirements.
  • Strong understanding of and experience with the skills that are required in product management and marketing.
  • Expert level ability with Microsoft Office programs, particularly Word, Excel, PowerPoint, and Access.
  • Advanced ability in diagnostic coding.
  • Exceptional oral and written communications skills, including both the ability to translate your ideas into a clear written format, and strong enough personal communication abilities to meet with customers or speak in front of a group at a seminar.
  • The ability to ask the right questions to elicit business requirements, and an understanding of how to document those clearly.
  • Expert-level skills in organization and planning.
Preferred but NOT required:
  • A clinical background, especially as a nurse or coder, would be helpful.
  • Software development experience.
  • Experience writing SQL.
  • Experience working with an off-shore development and QA team would be a plus.
  • Knowledge of the Voyager system.
You’ll travel approximately 15-25% of your time domestically in order to meet sales and implementation requirements. This may include visiting clients, helping with implementations, or presenting at seminars or trainings as the subject matter expert for Risk Adjustment.

The Role

As an experienced product or development manager with experience managing a Risk Adjustment (RA) program, you will already have deep knowledge and understanding around the capabilities and market requirements for the RA modules and solution. Reporting to the Director of Product Management, you will own our RA product, manage our processes, and act as subject matter expert for RA calculations, payment methodologies, compliance, and systems. Quick question for you - click here

Your goal will be to manage and enhance the product module features by creating an ongoing roadmap of product priorities, documenting and developing requirements, monitoring and communicating compliance changes, and interacting with cross-functional teams to assist in sales, implementation, and development. You will have one Business Analyst (BA) who reports directly to you. You’ll direct the BA’s workload and activities on a day-to-day basis, provide guidance regarding module priorities so they can write requirements at your instruction, and give input for performance reviews.

Most of your time will be spent planning, altering requirements, and supporting various teams from a sales perspective, with implementation, or providing content for documentation. To complete these tasks, you’ll work with teams across the organization, participate in a constant planning cycle, interact to ensure everyone is aware of customer inquiries, keep the team apprised of compliance items, develop content for the sales team, participate in demos and RFP responses, and complete any overflow requirements for writing and software development. In short, you’ll do whatever it takes to keep things running smoothly for the RA product.

We currently work with an offshore development team in India, which will require some non-standard business hours (such as meetings at 9:30 pm). It may also require that you be plugged in and responsive from home to provide quick answers to emails or other communications as needed.

In addition to the above, some of your specific tasks will include:
  • Defining and articulating high-level product requirements, while researching all related compliance memos and guidance from CMS.
  • Working with the Product Development team on translation of requirements and validation of product development throughout the development life cycle.
  • Participating in decisions related to product development critical issues and conflicts.
  • Creating and documenting the RA modules roadmap.
  • Developing rollout (including operational readiness requirements) for new products, solutions, and/or significant releases.
  • Providing education, updates, and product information, as well as providing input to RFP responses and creating presentations, to enable Sales Support.
  • Speaking as a representative of Dynamic and an industry expert at conferences and industry events, and contributing to white papers and case studies.
  • Assisting in building and/or review of test plans for product releases and new functionality, and performing some high-level testing.
  • Assisting the implementation team as needed.
  • Providing consulting and training services to clients as needed, working to create and improve their RA operations and practices, and identifying innovative ways to solve their business problems.
Note: this description is intended to give you a general overview of the position and is not an exhaustive listing of duties and responsibilities.

Why Dynamic

High impact and visibility -- as our RA product manager, you will play a key role for our company. You’ll have the chance to shape the future direction of our products, as well as acting as a subject matter expert who has a direct, positive impact on the organization, and the industry.

Growth-driven career development -- we are looking for high impact players who can take on larger roles and responsibilities and continue to grow with our organization. The internal and external exposure you gain will position you to grow your career and take it to the next level.

No slowdown in sight -- the immediate and long-term prospects are positive in our industry. Consider:
  • Not only is the Medicare population growing, but Medicare funding is also increasing. For example Congress recently reauthorized a $32.8 billion, 4-year expansion of the State Children’s Health Insurance Program (SCHIP), extending healthcare coverage to an additional 4 million children over the next 4 years.
  • The Centers for Medicare and Medicaid Services (CMS) forecasts expenditures for Medicaid will continue to grow, doubling current spending by 2015.
  • While the healthcare industry has been relatively slow to embrace the benefits of IT, the demand is accelerating, in part driven by the fact that policy leaders and the voting public are paying close attention to cost containment and payment accuracy -- benefits the Voyager Suite provides.
Variety and continuous learning -- when you are working for a plan you learn how to do risk adjustment one way, but at Dynamic, you not only have the clients that we currently work with, but we are constantly working with new clients. If you have a passion for RA, this is a unique opportunity to expand your knowledge base and learn new ways of performing your RA functions.

Empowerment -- we’ll entrust you with the freedom and flexibility to drive processes to meet our risk assessment objectives and achieve success.

Great culture -- we take tremendous pride in our high performance culture and here you’ll find not only the excitement and fast-paced energy of a growing organization but also the camaraderie of a smaller organization where everyone is passionate about what they do and infused with a spirit of continuous improvement. We believe our rock star employees are our biggest assets and we are committed to investing in our people and processes.

Excellent compensation -- in addition to a competitive salary and bonus opportunity, you’ll enjoy a comprehensive benefits package that includes medical/dental coverage; a 401(k) plan; PTO & holidays; and more.

Keys to Success

In this size company, you’ll find yourself with the opportunity to stretch your skills and do a variety of different tasks, and you’ll need a broad range of expertise to seamlessly handle this wide range of activities. We’re looking for someone who can discuss RA strategy, program implementation and other complex topics one day, but then translate your thoughts to paper to write up detailed requirements for a new module or tear into data analysis the next day. It will be important that you’re able to understand the entire applications development business lifecycle.

At Dynamic Healthcare Systems, our customers and their needs are at the core of everything we do. We expect everyone in the business to take responsibility for ensuring the loyalty and satisfaction of our customers. You will collaborate with cross-functional teams, but will also need to be able to work autonomously to achieve these goals.

About Dynamic

As the recognized leader in the industry and a company that is experiencing exceptional growth, our focus on the CMS business uniquely positions us to identify the challenges that health plans, MSOs and IPAs encounter when managing the ever-changing Medicare managed care business. We bring both technology solutions that solve operational and compliance problems, and the consulting expertise to help our clients navigate the unpredictable waters of the Medicare Advantage business.

Dynamic has attracted accomplished healthcare professionals who bring decades of experience in managed care operations, technology design, information technology, customer service, Medicare product design, product development, business consulting and financial services.

Headquartered in Irvine, California, Dynamic provides its people with an exciting, challenging and creative environment. Our solutions provide stellar results for our customers; our employees make it happen!
Dynamic Healthcare Systems is an equal opportunity employer. EOE/AA/M/F/Vets/Disabled
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Resume Supplement
Please take a few minutes to answer questions about your background and expertise specific to the Senior Product Manager, Risk Adjustment position.

Question Yes No Comment
Are you legally authorized to work permanently in the United States for any employer WITHOUT REQUIRING A VISA TRANSFER or VISA SPONSORSHIP?
Do you currently live within a reasonable and realistic commuting distance from Irvine, CA?
Do you have a VERIFIABLE Bachelors or higher degree?
Are you willing & able to travel nationwide, up to 40%?
Item Years of experience Expertise level Comment
Please indicate your years of experience and your level of expertise (0 = none, 5 = expert) in each of the areas below. Experience with all items is not necessarily required.
Knowledge of CMS regulatory environment:
Medicare Risk Adjustment Operations Management:
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RAPS data/operations:
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