Innovaccer

• Own end-to-end commercialization of Innovaccer's managed services offerings. We need a product manager who understands RCM Services is the product. • Develop and maintain a comprehensive services catalog, including service descriptions, scope parameters, and delivery expectations • Author and manage SKU definitions aligned to how sales teams configure and quote services deals • Draft and maintain Statement of Work (SOW) templates that accurately reflect deliverables, timelines, and responsibilities • Define pricing structures and models, including per-transaction, per-claim, and outcome-based constructs • Partner with marketing to develop positioning, messaging, and collateral that drives services attach and pipeline • Lead the organizational effort to embed AI into the services delivery model. • Develop a structured adoption roadmap for AI and automation tooling across services operations • Build internal business cases that quantify efficiency gains, error reduction, and capacity impact • Drive change management by working directly with services team leads to build comfort with AI-assisted workflows • Establish adoption metrics and report on AI utilization, impact, and ROI to senior leadership • Identify where the services organization is losing time, accuracy, or throughput and map those gaps to specific AI or automation opportunities. • Conduct structured reviews of services workflows to surface inefficiencies in coding, authorization, documentation, and billing processes • Prioritize operational improvement opportunities by impact, feasibility, and strategic alignment • Develop the precise, detailed documentation that engineers and product teams need to automate or augment clinical and billing workflows with confidence. • Own the services automation capability roadmap, ensuring backlog reflects both strategic priorities and operational demand • Maintain weekly status reporting across commercialization and automation workstreams • Track activity, milestones, and blockers across cross-functional teams; escalate proactively • Build and manage project plans with clearly defined owners, timelines, and dependencies

• Strategic Ownership of Population Health and AI Platform Clients: Serve as the executive owner for a portfolio of strategic accounts, ensuring the continued success, retention, and expansion of Innovaccer’s population health platform while also driving adoption and successful delivery of the AI platform. • Platform Delivery and Adoption Leadership: Ensure successful deployment, operationalization, and scaling of the enterprise platform. Partner with client executives to embed platform into core operational workflows and enable scalable AI-driven transformation. • Account Growth: Build a partnership-focused account growth strategy and ensure region growth targets are achieved by expanding the scope of platform use and introducing new products to current customers • C-Suite Partnership: Serve as a trusted advisor to CIOs, CFOs, COOs, CMIOs, and CEOs. Translate Innovaccer’s population health and AI platform capabilities into boardroom-level discussions tied to ROI, operational efficiency, and strategic transformation. • Strategic Account Leadership: Own and deliver on CARR, ARR growth, churn reduction, NPS, and CSAT across both population health platform and AI platform accounts. • Delivery Accountability: Partner closely with delivery, product, engineering, and AI teams to ensure successful deployment and adoption of both the population health platform and AI platform. Ensure delivery execution meets client expectations and drives measurable outcomes. • Customer Success Leadership: Mentor and develop Customer Success Leaders to manage complex client relationships, ensuring they can effectively support both population health platform deployments and enterprise AI platform adoption. • Cross-Functional Alignment: Work closely with Sales, Product, Engineering, AI, and Delivery teams to align platform roadmap, delivery execution, and client success strategy. • Platform Adoption and Expansion: Drive expanded adoption across multiple domains, helping clients maximize value from the population health platform while expanding into AI platform to support broader enterprise transformation. • Executive Presence and Client Engagement: Maintain consistent executive engagement with client leadership, ensuring Innovaccer is positioned as a long-term strategic partner supporting both population health and AI platform initiatives.

• Report to the Director, Clinical Transformation and work closely with the Payer Account Management and Accounting teams to ensure accurate, timely invoicing and payment distribution across PQS Enhanced Services programs. • Responsible for end-to-end payment operations—from invoice review and revenue tracking to disbursement coordination with PSAOs, chain pharmacies, and independent pharmacy organizations. • Collaborate with Payer Account Managers to review monthly invoices for Enhanced Services programs for accuracy. • Collaborate with Payer Account Managers to review invoicing monthly, quarterly and bi-annually. • Send finalized pharmacy and PQS invoice details to the accounting department for each payer on a monthly basis. • Work with the payer team to ensure new program invoices are generated as programs go live. • Coordinate on Payment process with Finance and Accounting teams including verification of independent pharmacy affiliations, sending revised payment details for disbursement, and collecting W-9 and EFT information from organizations. • Follow up with accounting and payer account managers on in-progress and delayed invoice payments. • Track PQS revenue for Enhanced Services payments and track payments by payee to support timely and accurate disbursement to pharmacies. • Answer all payment-related tickets and inquiries from organizations and pharmacies. • Work collaboratively with all PQS staff and its parent companies to ensure that PQS’ mission and plans are carried out successfully.

• Create world class customer facing documentation which would delight and excite customers • Remove ambiguity in understanding things by documenting things and hence making the teams more efficient and effective • Convert tacit knowledge to implicit knowledge

• Deliver ongoing clinical training, workflow support, and best-practice recommendations. • Act as a trusted advisor to clinical leaders, care managers, physicians, and operational teams. • Monitor adoption, identify gaps, and recommend optimization strategies from a value framework. • Support change management initiatives by helping customers adapt workflows and processes. • Translate clinical requirements—care management, quality improvement, chronic disease management, utilization management—into solution configurations. • Advise customers on best practices for workflow design, assessments, protocols, risk stratification, and care coordination. • Lead clinical discovery sessions to capture requirements and align platform capabilities with clinical objectives. • Configure and optimize clinical programs, protocols, assessments, and workflows within the platform. • Ensure solution design aligns with evidence-based practices and compliance requirements (e.g., HEDIS, CMS, value-based care models). • Collaborate with product, engineering, and implementation teams to ensure successful delivery and adoption. • Influence product enhancement and development through clinical insight from the field. • Collaborate with Product and Engineering teams to advise on roadmap items based on clinical trends and customer needs. • Work with Marketing to develop clinically accurate content, case studies, and customer success stories. • Support implementation teams during client onboarding to ensure seamless clinical workflow activation and program launch. • Partner with Customer Success on retention and expansion strategies grounded in clinical outcome data. • Review program performance data to identify trends, gaps, and opportunities for improvement. • Provide clinical interpretation of analytics, care gaps, risk stratification, and quality measures. • Partner with customers to create performance improvement plans and measure outcomes. • Bring clinical insights from customer engagements to inform product roadmap prioritization and program development. • Stay up-to-date on clinical standards, regulatory changes, and value-based care models (CMS, HEDIS, ACO, MA, JCAHO, NCQA, etc.). • Represent the company at conferences, webinars, and industry events as a clinical voice as needed. • Bring clinical insights from customer engagements to inform product roadmap prioritization and program development.

• Define and execute the overall strategy for Innovaccer’s Life Sciences business, aligned with company vision, goals, and growth objectives. • Identify growth opportunities across the Life Sciences market, including expansion of existing solutions and development of new products, services, and partnerships. • Lead the creation and execution of business plans that drive revenue growth, market share, and profitability within the Life Sciences vertical. • Build and maintain executive relationships with key Life Sciences stakeholders, including pharmaceutical companies, biotech firms, CROs, and medical device organizations. • Identify and pursue new business opportunities, including strategic partnerships and alliances, to expand Innovaccer’s Life Sciences footprint. • Lead complex negotiations and commercial discussions with strategic clients and partners. • Bring a strong point of view on customer needs, competitive landscape, and regulatory requirements (e.g., FDA, GxP) to inform product strategy and differentiation. • Jointly define product direction and business plans for Life Sciences-focused solutions, ensuring alignment with market demand and compliance requirements. • Partner with Product, Engineering, and Marketing teams to ensure successful launch, adoption, and scaling of Life Sciences solutions. • Own OKRs and financial metrics (CARR, NPV + CARR) for the Life Sciences business. • Oversee GTM planning, resource allocation, and performance management. • Lead, mentor, and develop a high-performing Life Sciences team, fostering a culture of excellence, accountability, and continuous improvement. • Provide regular updates to executive leadership on business performance and progress. • Engage and grow C-level relationships across Life Sciences clients and partners. • Leverage strategic partnerships to drive new client acquisition and expand client value delivery.

• The Medical Coder is responsible for independently reviewing, analysing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. • This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. • The Medical Coder works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. • This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment. • Averages 10 front-end holds per hour • Maintains a minimum of 90% coding accuracy. • Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment. • Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses. • Ensures all diagnosis codes meet local and national medical necessity guidelines. • Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services. • Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality. • Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices. • Independently reviews and resolves all assigned front-end claim holds. • Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead. • Escalates identified client trends to the assigned Coding Team Lead. • Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification. • Maintains and completes all CEU requirements. • Performs other duties or tasks as assigned.

• The Medical Coder is responsible for independently reviewing, analysing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. • This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. • The Medical Coder works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. • This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment. • Averages 10 front-end holds per hour. • Maintains a minimum of 90% coding accuracy. • Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment. • Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses. • Ensures all diagnosis codes meet local and national medical necessity guidelines. • Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services. • Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality. • Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices. • Independently reviews and resolves all assigned front-end claim holds. • Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead. • Escalates identified client trends to the assigned Coding Team Lead. • Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification. • Maintains and completes all CEU requirements. • Performs other duties or tasks as assigned.

• The Medical Coder is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. • This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. • The Medical Coder works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. • This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment.

• Compile, clean, and validate healthcare claims and enrollment data for use in actuarial analyses. • Assist with medical cost and utilization analyses, including trend calculations, PMPM reporting, and benchmark comparisons. • Support rate development and rate review work by preparing data exhibits, trend summaries, and documentation under the direction of senior staff. • Maintain and update actuarial models and exhibits under the direction of senior staff. • Write and maintain SQL queries and data scripts to extract and manipulate data from healthcare claims databases. • Prepare exhibits, tables, and supporting documentation for client deliverables and internal reports. • Research CMS program guidelines, rate notices, and policy updates to support team knowledge. • Participate in internal training sessions and support knowledge sharing across the actuarial team. • Actively pursue actuarial exam progress with support from the company's study program.