3663 - Product Manager

Role Summary

We are seeking a highly skilled Product Manager to lead the strategy, development, and optimization of our AI-driven Prior Authorization (PA) portal, a core product enabling payers, providers, and members to navigate clinical approvals with greater speed, transparency, and accuracy. This role combines deep healthcare domain expertise, strong product leadership, and experience with AI/ML to build a compliant, intuitive, and scalable platform. You will own the end-to-end product lifecycle—from vision and roadmap planning through delivery, outcomes measurement, and continuous improvement. You will work cross-functionally with engineering, clinical, data science, compliance, payer operations, and customer success and to ensure the product drives measurable reductions in administrative burden, turnaround time, and inappropriate utilization.

Key Responsibilities Product Strategy & Delivery

● Define and maintain the product vision, long-term strategy, and KPIs ● Assess market trends, regulations and competitive landscape to identify product opportunities. ● Translate payer and provider needs into a clear, prioritized roadmap. ● Lead the end-to-end delivery of features: requirements, user stories, acceptance criteria, release planning, and iteration. ● Own backlog grooming and sprint prioritization in partnership with Engineering and Design. ● Drive high-quality UX for provider workflows, ensuring clarity and reducing friction. AI & Technology Leadership ● Partner with data science and engineering teams to leverage NLP, LLMs, rules engines, and predictive models for: ○ Automated medical necessity checks ○ Automated eligibility checks ○ Clinical documentation extraction ○ Real-time PA requirement detection ○ Prior authorization triage and auto-approval workflows ○ Interoperability with EHRs and payer systems (FHIR, X12, APIs)

Stakeholder Management

● Serve as the product point of contact for payer executives, medical directors, provider groups, and internal teams. ● Gather and synthesize feedback from clinical reviewers, utilization management staff, and provider users. ● Communicate roadmap, priorities, timelines, and performance updates to leadership.

Compliance & Quality ● Ensure product alignment with CMS, NCQA, URAC, HIPAA, and state-level UM regulations. ● Incorporate clinical guidelines into decisioning frameworks. Partner with legal and compliance to maintain auditability, transparency, and documentation standards.

Metrics & Outcomes

● Define and monitor product performance measures (e.g., TAT reduction, auto- determination rate, provider satisfaction, cost-savings). ● Lead A/B tests and experiments to optimize approval accuracy and reduce administrative overhead. ● Drive customer ROI and adoption by demonstrating consistent value creation.