Lead Product Manager - Interoperability Prior Authorizations
New
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JobgetherHealthcare Technology
Fully remote work opportunity available nationwide within the United States.Full-TimeLead
SalaryAnnual base salary range of $126,300–$173,700
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Job Details
- Experience
- 8+ years of experience in Product Management, Healthcare Technology, Clinical Operations, Utilization Management, or a related field.
- Required Skills
- Product ManagementRESTful APIs
Requirements
- Bachelor's degree or equivalent practical experience.
- 8+ years of experience in Product Management, Healthcare Technology, Clinical Operations, Utilization Management, or a related field.
- Demonstrated expertise with medical prior authorization and/or electronic prior authorization workflows.
- Strong understanding of healthcare payer operations, utilization management, clinical review processes, and provider workflows.
- Experience interpreting and implementing CMS regulations, healthcare interoperability requirements, and regulatory-driven product capabilities.
- Proven ability to develop product strategies, visions, and roadmaps while delivering measurable business outcomes.
- Experience leading complex cross-functional programs involving clinical, operational, technology, compliance, and business stakeholders.
- Strong requirements-gathering and prioritization skills.
- Excellent stakeholder management, communication, presentation, and influencing skills.
- Experience with prior authorization modernization, automation, or digital transformation.
- Familiarity with healthcare interoperability standards and technologies such as FHIR, APIs, HL7, and related healthcare data-exchange frameworks is preferred.
Responsibilities
- Define and execute the product vision, strategy, and roadmap for medical prior authorization and electronic prior authorization (ePA) capabilities.
- Partner with clinical, business, operational, technology, compliance, provider, and utilization management stakeholders to identify opportunities and improve authorization workflows and customer experiences.
- Translate complex clinical, operational, business, and regulatory requirements into clear product solutions, business requirements, user journeys, implementation plans, and measurable success criteria.
- Lead complex cross-functional initiatives from discovery through delivery, collaborating closely with Product Owners, Engineering, and delivery teams to ensure successful execution.
- Drive simplification, automation, and operational efficiency across prior authorization processes while reducing administrative burden for providers and members.
- Build and maintain strategic relationships with EHR/EMR vendors, interoperability partners, industry organizations, clearinghouses, and other external stakeholders.
- Monitor CMS regulations, interoperability requirements, healthcare technology trends, and industry developments to ensure product strategies remain compliant and forward-looking.
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