Product Owner – RCM Automation, AI

Role Overview

• Define and deliver AI-powered RCM capabilities, including policy extraction agents, claim scrubbers, denial risk models, and intelligent automation workflows
• Translate billing and payer policy complexity into structured logic suitable for AI models and rule engines
• Collaborate with AI/ML engineers to define model inputs, outputs, evaluation criteria, and success metrics
• Contribute to prompt engineering for LLM-based workflows, ensuring structured, testable, and reliable outputs aligned with billing accuracy standards
• Participate in model evaluation, output validation, and iterative refinement to improve precision, recall, and operational trust
• Use SQL and data analysis to identify trends in denials, scrub failures, payer policies, and operational inefficiencies
• Support data orchestration efforts by defining required datasets, feature inputs, and transformation logic
• Analyze automation performance using measurable KPIs (e.g., denial reduction, touch-time savings, automation rates)
• Partner with engineering on experimentation frameworks and structured model testing
• Convert high-level business problems into detailed epics and user stories with clear acceptance criteria
• Create flow maps and workflow diagrams to communicate business logic, automation rules, and agent behavior
• Break down AI and automation initiatives into incremental, deliverable features aligned with PI objectives
• Ensure requirements address edge cases, data dependencies, and workflow impacts across enterprise and RCM users
• Participate in SAFe Agile ceremonies, including backlog refinement, sprint planning, and stand-ups
• Own JIRA epics and stories from concept through release
• Triage and prioritize bugs, especially those related to AI output accuracy and automation reliability
• Perform functional validation and assist in model output certification before release
• Partner with Product Launch, Training, Support, Implementation, and RCM Operations to ensure successful feature rollout
• Manage alpha and beta programs, gathering structured feedback to improve AI performance and usability
• Act as a change agent promoting intelligent automation and measurable efficiency improvements across customer workflows

Requirements

• 5+ years of experience in healthcare technology, with strong knowledge of medical billing and revenue cycle operations
• Deep understanding of claims lifecycle, denials, payer policies, coding, modifiers, and appeals
• Experience defining functional requirements in the form of user stories, process flows, and structured business logic
• Basic working knowledge of SQL and ability to use data to support prioritization and validation
• Foundational knowledge of AI/ML concepts, including: Large Language Models (LLMs), Agentic workflows and orchestration frameworks, Model evaluation metrics (precision, recall, accuracy), Prompt engineering for structured, reliable outputs
• Ability to collaborate effectively with AI engineers on model behavior, testing, and refinement
• Strong analytical thinking, problem-solving skills, and attention to detail
• Experience working in Agile environments (SAFe preferred)
• Familiarity with Jira, Confluence, and Google Suite
• Experience working across distributed teams and time zones

Tech Stack

• SQL

Benefits

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits
• Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US)
• Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch
• Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters