Availity

Where healthcare connects. Now Hiring!

Product Manager, Prior Authorizations

Product ManagerProduct ManagerFull TimeRemoteTeam 1,001-5,000Since 2000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

59 days ago

Salary

Not specified

Bachelor Degree5 yrs expEnglish

Job Description

• Define and communicate a clear product roadmap aligned with CMS requirements, industry trends, and organizational goals • Gather and document business requirements through stakeholder interviews and workflow analysis • Translate requirements into user stories, acceptance criteria, and API specifications for engineering teams • Validate interoperability standards (X12 278, FHIR CRD/DTR/PAS) for transactions between EHRs, Availity, and payer/vendor systems • Collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases • Serve as the subject matter expert on prior authorization workflows and FHIR standards; provide guidance internally and externally • Monitor CMS mandates, industry trends, and client feedback to inform product decisions and prioritize features • Lead pilots, define KPIs/OKRs, and drive successful go-to-market strategies • Define product performance metrics and partner with data teams to deliver actionable insights for ROI and gainshare • Align executives, clients, and internal teams on product vision, progress, and outcomes

Job Requirements

  • Minimum of 5 years’ experience in Product Management preferably with client facing experience within healthcare technology
  • Deep expertise in prior authorizations workflows
  • Strong technical background with an understanding of the CMS 0057-F requirements for prior authorization and the X12 278 EDI and FHIR prior authorization (CRD, DTR, and PAS) transactions
  • Knowledge of EHR systems and utilization management platforms and vendors
  • Technical acumen, ability to gather and describe market requirements and get feedback from technical staff and customers
  • Business acumen: ability to contribute to a business case, evaluate feasibility & scalability, and driving ROI
  • Familiarity with regulatory requirements and compliance standards
  • Proven ability to lead cross-functional initiatives and influence stakeholders

Benefits

  • Competitive salary
  • Bonus structure
  • Generous HSA company contribution
  • Healthcare benefits
  • Vision benefits
  • Dental benefits
  • 401k match program on day one
  • Unlimited PTO for salaried associates + 9 paid holidays
  • 19 days of PTO for hourly associates
  • Gym membership reimbursement up to $250/year
  • Education reimbursement
  • Paid Parental Leave for both moms and dads

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