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Role Description

The Technical Product Manager role for Clinical solutions merges product management, healthcare expertise, and technical knowledge to develop and manage software and technology solutions for Alignment Health.

• Drive the functional and technical roadmap for Clinical Solutions, including Utilization, Care Management platforms, Clinical decision support systems, quality measures, and interoperability solutions leveraging Alignment’s proprietary AVA and Vendor platforms.
• Ensure compliance with CMS, NCQA, HIPAA, and other regulatory requirements impacting clinical data and processes.
• Anticipate regulatory and operational changes (e.g., CMS rule updates, encounter data submission requirements) and integrate them into the roadmap.
• Lead the design, testing, and implementation of new features for Clinical solutions platforms.
• Define and drive integration with Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and other clinical data platforms via APIs, HL7, FHIR, and batch interfaces.
• Partner with data engineering teams to design solutions that support risk adjustment, HEDIS/Stars quality reporting, care gap closure, and population health analytics.
• Define and prioritize features for provider-facing tools such as prior authorization, utilization management, case management, and clinical documentation improvements.
• Collaborate with clinicians, business stakeholders, and technology teams to translate clinical workflows and requirements into scalable technical solutions.

Qualifications

• 5+ years of Product Management experience in healthcare technology, with a focus on clinical solutions.
• Advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred.
• Proven hands-on expertise with healthcare interoperability standards (FHIR, HL7, X12, CCD, CDA).
• Microsoft SQL (querying, optimization, reconciliation, audits).
• ETL Tools such as Microsoft SSIS and Azure Data Factory.
• Cloud Platforms (Azure/AWS).
• Experience integrating vendor solutions.
• Strong knowledge of clinical workflows, care management, utilization management, and quality reporting.
• Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes.

Requirements

• Bachelor’s degree in Healthcare Information Systems, Computer Science or related field; advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred.
• MBA or advanced degree preferred.
• Deep understanding of Provider Credentialing, Contracting and Reimbursement Strategies in a Medicare environment.
• Experience with Medicare and Medicaid programs, including Stars, HEDIS, and risk adjustment.
• Knowledge of clinical natural language processing (NLP) or AI-driven care management tools.
• Proficiency in relevant technical tools, such as SQL, Azure Data Factory, Jira, and Confluence.
• Experience in defining product strategies, managing product backlogs, and working within agile development methodologies.
• Familiarity with payer platforms (Facets, QNXT, HealthRules) and provider EMRs (Epic, Athena, Cerner, Allscripts).
• Vendor management and SLA performance oversight.

Benefits

• Pay Range: $113,332.00 - $169,999.00
• Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.