Who We Are
Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.
Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.
Who You Are
You are a Medicare Advantage Stars Senior Product Manager who connects CMS regulatory requirements, health plan quality strategies, data analytics, and product development into practical solutions for customers. You will serve as a subject matter expert within the talent acquisition team’s hiring scope for this role, partnering across product, engineering, analytics, and client-facing teams to support Inovalon’s Medicare Advantage Stars offerings. In this role, you help shape products and insights that enable health plans to understand performance, identify gaps, and respond to a complex and evolving Stars environment.
What You'll Do
- Interpret CMS Medicare Advantage and Part D Stars regulations, technical specifications, and guidance, including Advance Notices, Final Rules, Rate Announcements, and Technical Notes, and translate them into clear business and product implications.
- Serve as the internal subject matter expert on Medicare Advantage quality measurement, performance improvement, and Stars methodology, including measure changes, benchmarks, cut points, weighting, and year-over-year impacts.
- Define business and functional requirements for Medicare Advantage Stars technology and analytics products by converting regulatory and measure specifications into data requirements, workflows, calculations, and user needs.
- Partner with product, engineering, data analysts, and data scientists to build and enhance tools that identify performance gaps, forecast Star Ratings, and support quality improvement strategies.
- Support user acceptance testing for Stars-related functionality to validate that products, calculations, and workflows align with CMS requirements and intended business outcomes.
- Engage directly with Medicare Advantage health plan customers to understand their Stars strategies, quality challenges, operational priorities, and data environments.
- Analyze plan performance data to identify gaps, root causes, trends, and opportunities for improvement across measure-level performance and overall ratings.
- Present complex regulatory, analytical, and product findings clearly to executives, quality leaders, and technical and non-technical audiences, including at industry events.
- Translate analytical findings into practical recommendations for both health plan customers and internal product development teams.
What You'll Need
- 5+ years of software product management experience managing platform or integration products required, 5+ years of healthcare information technology experience with a focus on partner integration products required, and 5+ years of experience with Medicare Advantage Stars and CMS quality programs gained at a health plan, healthcare technology company, consulting organization, or similar organization supporting Medicare Advantage plans required.
- Bachelor’s degree in healthcare administration, public health, business, data analytics, health informatics, nursing, or a related field, or equivalent combination of education and experience required.
- Strong understanding of CMS Medicare Advantage Stars measures, including HEDIS, pharmacy, CAHPS, HOS, operational, and improvement measures, as well as methodology, regulations, and quality improvement programs.
- Strong analytical and problem-solving skills, with the ability to interpret complex regulatory and technical documents and translate them into practical business and technology requirements.
- Excellent written, verbal, and presentation skills, with the ability to communicate effectively across executives, quality leaders, product managers, analysts, engineers, and developers.
- Experience working in fast-paced environments and collaborating in Agile product development settings.
- Growth Potential & Learning Agility: Demonstrates curiosity and learns quickly in evolving regulatory, product, and customer environments, applying new knowledge to improve products and performance.
- Leadership: Builds trust, influences cross-functional partners, and works through differing perspectives to align product, analytics, and customer priorities.
- Adaptability: Adjusts effectively to changing CMS guidance, shifting business needs, and evolving product requirements while staying focused on outcomes.
- Creative Thinking: Develops practical, innovative approaches to connect regulatory requirements, analytics, and product capabilities in ways that create customer value.
- Analytical Skills: Uses data, logic, and evidence to evaluate Stars performance, identify meaningful patterns, and support sound product and business decisions.
- Nice to have: Experience building healthcare technology products involving Medicare Advantage Stars, quality, analytics, or regulatory compliance; experience with Medicare Advantage quality data sources including HEDIS, CAHPS, HOS, claims, encounter, pharmacy, and supplemental data; familiarity with CMS Stars Technical Specifications, cut points, and benchmarks; Pragmatic Marketing experience or certification; and SaaS or cloud software experience.
Our Shared Commitments
- Maintain compliance with Inovalon’s policies, procedures and mission statement;
- Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; and
- Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of Employer.
Work Environment
- This is primarily a computer-based role performed in a remote, hybrid, or office environment. The role requires prolonged periods of computer use and frequent communication and interaction with others, either virtually and/or in person. The role may occasionally require transporting or moving work-related equipment weighing up to 10 pounds, such as a laptop and related materials. Some travel may be required, depending on the needs of the role. Reasonable accommodations may be provided to enable qualified individuals with disabilities to perform the essential functions of the position, consistent with applicable law.
This position is not eligible for immigration sponsorship (e.g. H-1B, TN, or E-3). Applicants must be authorized to work in the United States as a condition of employment. (This is only applicable for US-based positions)
If you don’t meet every qualification listed but are excited about our mission and the work described, we encourage you to apply. Inovalon is most interested in finding the best candidate for the job, and you may be just the right person for this or other roles.
By embracing inclusion, we enhance our work environment and drive business success. Inovalon strives to provide equal opportunities to the communities where we operate and to our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.
Inovalon is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.
To review the legal requirements, including all labor law posters, please visit this link
To review the California Consumer Privacy Statement: Disclosures for California Residents, please visit this link
Work Location: If the US position is listed as remote, employees who reside within a 40-mile radius of one of our office locations in Tampa, FL; Canonsburg, PA; or Bowie, MD will follow a hybrid work schedule and are expected to work in the office two days per week (Tuesdays and Wednesdays).