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Job Description
Structured overview of role & requirementsAbout This Role
Own and define product strategy and roadmap for prior authorization workflows and interoperability compliance aligned with CMS mandates.
Lead full lifecycle product management from ideation to launch, ensuring scalable and compliant solutions that streamline payer-provider interactions.
Serve as SME on prior authorization interoperability standards, represent company externally, and collaborate with cross-functional teams and industry workgroups.
Minimum Requirements
Deep expertise in prior authorization workflows is mandatory.
Strong technical knowledge of CMS 0057-F, X12 278 EDI, and FHIR prior authorization transactions (CRD, DTR, PAS).
Experience in product management or related roles within healthcare technology.
Video camera usage required for all virtual meetings as per company policy.
Ideal Candidate Profile
Experience bridging business and technical teams in healthcare product delivery, with familiarity of EHR and payer utilization platforms.
Ability to contribute to product business cases, prioritize features based on regulatory and ROI considerations, and lead cross-functional initiatives.
Demonstrated familiarity with Agile/Scrum, product management tools like Jira or Aha, and data analysis for actionable insights.