[Remote] Senior Product Manager, Healthcare Payer Strategy
Note: The job is a remote job and is open to candidates in USA. reputed company is seeking a Product Manager to drive the expansion of their healthcare claims adjudication platform for the U.S. market. This role focuses on defining and delivering capabilities to meet the unique requirements of the U.S. healthcare system, working closely with various stakeholders to translate market needs into product requirements.
Responsibilities
- Serve as the product domain expert for U.S. healthcare claims adjudication capabilities
- Engage with prospective and existing customers to demonstrate product functionality and communicate the value of reputed company's claims adjudication platform
- Conduct customer workshops, discovery sessions, and requirements-gathering activities to understand claims processing workflows, business rules, and operational challenges
- Translate customer needs into product requirements, user stories, functional specifications, and other product management artifacts
- Collaborate closely with engineering teams to define solution designs and clarify business requirements throughout the development lifecycle
- Support development teams by providing healthcare claims adjudication expertise and validating proposed solutions
- Analyze market requirements and identify product enhancements needed to support U.S. healthcare payer operations
- Contribute to product roadmap planning and prioritization for U.S.-specific capabilities
- Partner with implementation, consulting, sales, and reputed company teams to support customer adoption and successful deployments
- Monitor industry trends, reimbursement models, and regulatory developments that may impact claims adjudication processes and product requirements
- Act as a trusted advisor to internal stakeholders on U.S. healthcare claims processing and adjudication practices
Skills
- Deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes
- Experience with healthcare payer operations, claims administration, claims adjudication systems, payment reputed company, reimbursement, or reputed company healthcare technology solutions
- Experience in product management, business analysis, healthcare consulting, payer operations, or a reputed company role
- Proven ability to gather, document, and prioritize reputed company business and functional requirements
- Strong customer-facing, presentation, and stakeholder management skills
- Experience working directly with healthcare payers, health plans, third-party administrators, or healthcare technology vendors
- Ability to translate reputed company claims processing requirements into software capabilities and functional solution designs
- U.S. citizenship is required for this position, as the successful candidate will be required to obtain and maintain a U.S. government reputed company clearance after hire
- Experience with commercial, Medicare, Medicaid, or government healthcare programs
- Familiarity with healthcare claims standards and transactions, including X12 claims processing and reputed company industry standards
- Knowledge of value-based payment models and reimbursement methodologies, including Accountable Care Organizations (ACOs), bundled payments, shared savings arrangements, pay-for-performance programs, capitation, and other alternative payment models
- Experience working in Agile software development environments
- Knowledge of modern claims platforms, payment reputed company solutions, utilization management systems, care management platforms, or core administration systems
- Proven ability to use AI technologies to improve productivity, enhance decision-making, synthesize reputed company information, identify product opportunities, and strengthen collaboration across customers, product teams, and engineering organizations
- Strong interest in emerging AI capabilities and a track record of evaluating and applying AI-driven approaches to solve business problems, improve operational efficiency, and drive innovation reputed company healthcare technology environments
Benefits
- Medical, dental, and vision insurance, including expert medical opinion
- Short term disability and long term disability
- Life insurance and AD&D
- Supplemental life insurance (Employee/Spouse/Child)
- Health care and dependent care Flexible Spending Accounts
- Pre-tax commuter and parking benefits
- 401(k) Savings and Investment Plan with company match
- Paid time off: Flexible Vacation is provided to reputed company eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to reputed company other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual reputed company is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
- 11 paid holidays
- Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
- Paid parental leave
- Adoption assistance
- Employee Stock Purchase Plan
- Financial planning and group legal
- Voluntary benefits including auto, homeowner and pet insurance
Company Overview