Professional Services Manager (HEDIS and Risk Adjustment)

Company: Inovalon, Inc.
Location: Bowie
Posted on: May 17, 2025

Job Description:

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.
Overview: Inovalon's Professional Service team has a significant influence on how customers implement, adopt and utilize our SaaS solutions. For our Health Plan and Risk-bearing partners, partnering with Inovalon's Professional Services team will accelerate time to value, elevate utilization of the product and increase overall satisfaction with Inovalon's products.
The Professional Services Manager is responsible for the execution and management of complex engagements designed to drive business outcomes for Inovalon's Payer Business Unit Customers. This is a client facing position accountable for supporting customers through the delivery of Professional Services offerings, including consulting services, delivering Quality and Risk Adjustment best practices within a consultative or managed service framework.
Duties and Responsibilities:
* Comprehensively manage concurrent customer Professional Service engagements across the company's Payer product portfolio
* Act as client-facing point of contact for all Quality/STARS/Risk related activities within assigned client engagements
* Act as trusted advisor to customers to understand their Quality and/or Risk Adjustment program goals, business drivers and help design, execute and monitor Professional Services to support customer outcomes
* Actively manage outstanding issues and drive issues to resolution while effectively managing client expectations
* Develop and maintain an industry and regulatory expertise from a Quality and Risk Adjustment perspective; author and advise the creation of industry thought capital
* Identify (and close) growth opportunities based on client needs, and partner with sales, implementation and customer success teams to ensure positive customer experience
* Establish a strong leadership shadow that reinforces the Inovalon values
* Demonstrate effective and clear written and verbal communication skills, specifically the ability to speak to technical customers, including the drafting of high-quality, written documentation and presentations for internal and external communications
* Deploy strong analytical and organization skills; have an ability to work independently and proactively, be accepting of ambiguity in a fast-paced environment
* 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
* Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company
* Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.

Job Requirements:
* Minimum of 5 years of health plan Quality, CMS STARS or Risk Adjustment program delivery experience
* Minimum of 3 years' experience working in customer-facing roles, either internal or external, with strong interaction, consultative skills and ownership for developing and deepening relationships, driving customer satisfaction and issue management
* Previous experience working in professional services or consulting, preferably with a focus on payer customers preferred
* Ability to identify customer needs in complex regulatory environments and successfully execute on solution delivery, issue resolution, retention, adoption and expansion strategies
* Excellent communication and presentation skills; with the ability to adapt communication style depending on audience (customers / internal partners / Leadership)
* Deep knowledge of health care data, billing practices and reimbursement models;
* Takes a proactive approach towards executing on numerous tasks and priorities simultaneously while also managing client relationships and expectations;
* Detail-oriented and the ability to work in a fast-paced environment;
* Tableau, SnowFlake and/or SQL experience a plus;
* Knowledge of and familiarity with Microsoft Office tools, including Access, Excel, Word, and Outlook;
* Previous experience with Inovalon tools a plus.

Education:
* Bachelor's degree is required (degree in health care, information systems, computer science, statistics, analytics or a related field of study is preferred).

Physical Demands and Work Environment:
* Sedentary work (i.e., sitting for long periods of time);
* Exerting up to 10 pounds of force occasionally and/or negligible amount of force;
* Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions;
* Subject to inside environmental conditions; and
* Travel for this position will include less than 5% locally usually for training purposes.
Inovalon Offers a Competitive Salary and Benefits Package
In addition to the base compensation, this position may be eligible for performance-based incentives.
The actual base pay offered may vary depending on multiple factors including, but not limited to, job-related knowledge/skills, experience, business needs, geographical location, and internal equity. At Inovalon, it is not typical for an individual to be hired at or near the top end of the range for their role, and compensation decisions are dependent upon the facts and circumstances of each position and candidate.
Inovalon invests in associates to help them stay healthy, save for long-term financial goals, and manage the demands of work and personal commitments. That's why Inovalon offers a valuablewith a wide range of choices to meet associate needs, which may include health insurance, life insurance, company-paid disability, 401k, 18+ days of paid time off, and more.Base Compensation Range$95,800-$139,893 USDIf 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

Keywords: Inovalon, Inc., Wilmington , Professional Services Manager (HEDIS and Risk Adjustment), Executive , Bowie, Delaware