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Availity

Where healthcare connects. Now Hiring!

Vice President, Product, Medical Cost Containment & Authorization

Vice PresidentVice PresidentFull TimeRemoteLeadTeam 1,001-5,000Since 2000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

1 day ago

Salary

Not specified

Seniority

Lead

Bachelor Degree10 yrs expEnglish

Job Description

• Lead the strategy, execution, and scale of Utilization Management (UM) product portfolio • Own an end-to-end product suite that blends AI-driven decisioning, healthcare interoperability, and deep UM expertise • Define and own the long-term product vision and roadmap for medical cost containment and authorization capabilities • Align product strategy with enterprise affordability, quality, and growth goals • Identify market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization • Lead the end-to-end product lifecycle from concept through launch, optimization, and sunset • Translate clinical, operational, and regulatory requirements into clear product requirements • Partner with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions • Ensure products support evidence-based medicine, medical policy, and evolving clinical guidelines • Oversee products supporting prior authorization and other reviews • Drive innovation in automation, rules engines, and AI-assisted review • Collaborate with stakeholders to ensure integrity and regulatory adherence • Support Sales and Client Management with product positioning, differentiation, and client engagement

Job 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

Benefits

  • Competitive salary
  • Bonus structure
  • Generous HSA company contribution
  • Healthcare, vision, dental benefits
  • 401k match program
  • Unlimited PTO for salaried associates + 9 paid holidays
  • Up to $250/year reimbursement for gym memberships and wellness programs
  • Education reimbursement
  • Paid parental leave for both birth and adoptive parents
  • Community engagement opportunities

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