CMS EDGE Server Product Manager – Principal – Architect

Role Overview

• Serve as SME for CMS EDGE Server, ACA Risk Adjustment, and Reinsurance programs
• Lead CMS EDGE Server implementations, enhancements, and operational support initiatives
• Ensure accurate and compliant submission of membership, claims, encounter, and supplemental data to CMS
• Drive data validation, reconciliation, and reporting quality improvements
• Partner with business, operational, compliance, and technical teams to resolve data and reporting issues
• Translate business requirements into product, process, and technical solutions
• Provide strategic advisory support to health plan clients on CMS reporting best practices

Requirements

• 7+ years of healthcare payer experience
• Deep expertise with CMS EDGE Server and ACA Risk Adjustment
• Strong understanding of Reinsurance, Risk Adjustment, and regulatory reporting requirements
• Experience with health plan membership, claims, and encounter data
• Proven implementation and client-facing consulting experience
• Strong knowledge of payer operations and data quality processes
• Excellent communication and stakeholder management skills

Benefits

• medical, dental, and vision coverage to employees and dependents
• a 401(k) plan with a generous employer match
• an employee stock purchase plan
• a generous Paid Time Off policy
• paid parental leave and adoption assistance
• Wellness Program supporting employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of employees throughout the year