Vice President, Product, Medical Cost Containment & Authorization
New
Remote, USFull-TimeVp
Salary not disclosed
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Job Details
- Experience
- 10+ years of experience in healthcare product management, medical management, or utilization management. 5+ years in a senior product leadership role.
- Required Skills
- Artificial Intelligence
Requirements
- Bachelor’s degree required
- Advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred
- 10+ years of experience in healthcare product management, medical management, or utilization management
- 5+ years in a senior product leadership role
- Deep expertise in prior authorization, utilization review, and medical cost containment strategies
- Strong understanding of managed care, payer operations, and healthcare regulations
- Experience working with clinical teams and medical policy development
- Background in digital health, automation, or AI-enabled clinical workflows
- Proven success launching complex, regulated healthcare products at scale
- Strategic product leadership and executive-level communication
- Ability to translate clinical and regulatory complexity into usable products
- Strong analytical and financial acumen
- Collaborative leadership across clinical, technical, and business teams
- Comfort operating in highly regulated, fast-changing environments
- Proven track record in building AI products from incubation to scale
- Experience disrupting an established healthcare workflow
Responsibilities
- Defining and owning the long-term product vision and roadmap for medical cost containment and authorization capabilities.
- Aligning product strategy with enterprise affordability, quality, and growth goals
- Identifying market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization.
- Leading the end-to-end product lifecycle from concept through launch, optimization, and sunset.
- Translating clinical, operational, and regulatory requirements into clear product requirements and prioritization.
- Partnering with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions.
- Overseeing products supporting prior authorization, concurrent review, retrospective review, and specialty management.
- Driving innovation in automation, rules engines, AI-assisted review, and straight-through processing.
- Collaborating with stakeholders across products to ensure integrity and regulatory adherence.
- Ensuring products comply with federal and state regulations (e.g., CMS, NCQA, URAC, state DOI requirements).
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