Lead the strategy, execution, and scale of the Utilization Management (UM) product portfolio
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 and regulatory changes impacting utilization management and authorization
Lead the end-to-end product lifecycle from concept through launch and optimization
Translate clinical, operational, and regulatory requirements into clear product requirements
Partner with engineering and data teams to deliver scalable, configurable solutions
Oversee products supporting prior authorization, concurrent review, retrospective review, and specialty management
Drive innovation in automation, rules engines, AI-assisted review, and straight-through processing
Collaborate with stakeholders to ensure regulatory adherence and impact quantification

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

Vice President, Product, Medical Cost Containment – Authorization

Key skills