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Role Description

The Senior Product Manager - RCM Billing and Payments is responsible for building and growing our end-to-end member billing, rewards, client invoicing, payment collections, posting and reconciliations, reporting and analytics, and supporting partner data exchanges. The role will drive has two charges:

• Enable seamless, standardized, and multichannel (API, EDI, and Batch) Data Exchange frameworks including ingestion, mapping, translation, validations and support overall data management and governance with vendors and partners to support critical billing and payment workflows.
• Build scalable solutions and workflow automation, ensuring the highest level of data quality standards. The PM will build, drive, and execute product strategy while providing exemplary leadership, mentorship and guidance to their teams.

This role will help shape and evolve the product function towards better processes, tooling, and execution as we aim to continuously improve our craft.

Key areas of ownership include:

• Leadership: Build and mentor high performing agile teams driving best in class execution and delivery of high-quality products.
• Discovery: Perform deep discovery and user research with stakeholders, members, internal users, while considering legal, regulatory and competitive and market dynamics. Bring qualitative and quantitative insights to the table for discussion.
• Strategy: Create and drive the member experience product strategy coupling the front-end user/member experience with a world class care team service experience. Collaborate and align strategy with relevant stakeholders including presenting to and working with senior leadership.
• Roadmap: Create, align, and provide cross org visibility to TPA Data roadmaps. This role is both responsible and accountable for all work that happens around internal and external data exchanges.
• Alignment: Create top down and bottoms-up alignment ensuring your direct, peers, teams, and senior leadership are providing the right level of guidance in accordance with RACI or similar.
• Experimentation: Set the bar for when and where to experiment. Bring a data-driven approach to building products but leverage your experience and product sense to deliver the right products on time and within budget. Perform rapid experimentation where needed, test manually, build stat sig experiments that prove and disprove our hypothesis.
• Approach: Apply product led growth concepts, letting our users (internal/external) shape our Analyze existing products, make the tough calls, say no, and create pitches and actionable plans for implementing new features. Make smart decisions applying 1 vs. 2-way door framework.
• Process: Refine and build process as needed to ship high quality products on time and in budget while ensuring visibility and alignment across the org. Manage the product development process and timeline to ensure targets are met on time and in budget.
• Billing and Payments: Support calculation and collection of member cost share, collections, administer rewards and benefits, client invoicing, collections, reconciliation, reporting & analytics.
• Enrollment, Eligibility, Accumulators, and Benefits Validation: Ingest multiple data sources – eligibility, claims, prior authorization feeds to drive our systems. Set specific standards and rules for the future to reduce operational overhead and increase simplicity in our service offering.
• Internal tools and systems: Refine and develop several internal tools and systems that service different parts of the business, for example identifying provider/facility targets, credentialing providers etc. to increase productivity.
• Health Plan and Partnership Integrations: Be an Advocate and Support the member’s experience in conjunction with relevant integrations through health plans and digital health partners.
• Reporting: Create scalable, accurate, differentiated internal and external reporting, including Executive Dashboards/KPI visualization and Client and Partner Reporting as a Product.

Qualifications

• 7+ years’ experience in Product Management, Healthcare Data Management or related fields.
• 5+ years in relevant specialty product area (Healthcare Payments, RCM, TPA, and X12 Data exchanges, technical services etc.).
• Healthcare or HealthTech experience required.
• Bachelor’s degree required.
• Experience with startup/growth phase company.
• Collaborating with both US and offshore teams.
• Experience with Agile Scrum Methodology.
• Ability to travel up to 1-2x/quarter.

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Short & Long Term Disability
• Life Insurance
• 401k with company match
• Flexible Paid Time Off
• Paid Parental Leave