Technical Product Manager – Healthcare Customer Service Solutions

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Job Overview:
We are seeking an experienced Business Product Manager with expertise in the US Healthcare payer domain to lead the integration of our Core Administration System, focusing on enrollment, claims, and payment functional areas. This role is critical to aligning our product strategy with business goals, ensuring seamless integration across systems, and driving product improvements that enhance member experience and operational efficiency. The ideal candidate has a solid understanding of healthcare payer processes and technical integration, with a strategic mindset and strong cross-functional collaboration skills.

Key Responsibilities:

1. Product Strategy and Vision

2. Develop and drive product strategy for the integration of the Core Admin System with a focus on enrollment, claims, and payment processes.

3. Align product vision with organizational objectives, regulatory requirements, and evolving industry standards within the US Healthcare payer space.
4. Conduct market research to identify trends, assess competitive positioning, and align product direction with industry demands within the healthcare payer space.

5. Identify and evaluate new opportunities for product enhancements that meet the needs of healthcare payers and their members.

6. Stakeholder Management

7. Act as the main point of contact between business units, IT, and external partners to ensure alignment on product goals and integration milestones.

8. Engage with stakeholders to gather insights, define product requirements, and communicate progress effectively.

9. Requirements Gathering and Analysis

10. Collaborate with product owners, business analysts, solution architects, and developers to define clear, comprehensive product requirements using prioritization techniques to align with strategic goals.

11. Utilize market insights, customer feedback, and business priorities to shape and prioritize product features.

12. Roadmap, PI Planning, and Project Management

13. Lead Program Increment (PI) planning sessions in alignment with SAFe principles to coordinate cross-team dependencies and define delivery timelines.

14. Maintain and communicate a detailed product roadmap that aligns with Agile practices, outlining key milestones for integration initiatives.

15. Collaborate with project management to monitor timelines, allocate resources effectively, and mitigate risks.

16. Cross-Functional Collaboration

17. Collaborate with technical teams on the implementation of integration solutions, ensuring alignment with product requirements and technical standards.

18. Work with QA teams to define test plans, ensure robust testing, and verify product performance post-integration.

19. Compliance and Risk Management

20. Ensure all integration processes comply with healthcare regulations, such as HIPAA, and manage associated risks.

21. Regularly update stakeholders on compliance, quality assurance, and performance metrics to ensure transparency and accountability.

Qualifications:

• Education
  : Bachelor's degree in Business Administration, Healthcare Management, Information Technology, or a related field. Master's degree is a plus.
• Experience
  : 5+ years of experience as a product manager or product owner or business analyst in the US Healthcare payer space, specifically in Core Admin System integration or related areas.
• Domain Knowledge
  : Deep understanding of healthcare payer processes, especially enrollment, claims, and payment workflows.
• Technical Skills
  : Familiarity with Core Admin System platforms, data integration, and interoperability standards (e.g., EDI, HL7, API integration).
• Product Management
  : Strong product management skills, with hands-on experience in prioritization techniques, roadmap planning, and PI planning
• Agile/SAFe:
  Solid experience with Agile methodologies; familiarity with SAFe is preferred; familiarity with SAFe is preferred.
• Soft Skills
  : Excellent communication, leadership, and problem-solving skills; ability to work effectively in cross-functional teams.
• Market Insight
  : Proficiency in conducting market research, analyzing competitive landscapes, and applying insights to product strategy.

Preferred Skills:

• Experience with specific Core Admin Systems used in healthcare (e.g., Facets, QNXT, HealthRules).
• Knowledge of regulatory compliance standards in healthcare, including HIPAA and CMS guidelines.
• Proven ability to manage multiple projects and deliver results in a fast-paced environment.
• Familiarity with SAFe methodologies and their application in large-scale environments.