Senior Product Manager – Healthcare Automation, Eligibility & Benefits

Role Overview

• Owns accountability for overall product and team success.
• Defines and communicates product vision aligned with business objectives and measurable outcomes.
• Develops and executes the product roadmap for healthcare automation capabilities supporting eligibility, benefits, plan configuration, and encounter readiness.
• Establishes strategy for automating eligibility and benefit workflows, including data ingestion, validation, exception handling, auditability, and operational controls.
• Partners across product domains to ensure benefit and eligibility capabilities support compliant ride decisioning and connect members with the appropriate care and transportation services.
• Identifies opportunities to leverage automation-first and AI-enabled approaches to improve scalability, accuracy, operational efficiency, and customer outcomes.
• Develops long-term product strategy informed by market trends, competitive analysis, regulatory requirements, and healthcare industry needs.
• Mentors Product Managers in strategic thinking and execution.
• Uses analytics to evaluate product performance, user behavior, automation effectiveness, operational workflows, and downstream data quality.
• Defines and monitors success metrics including automation rate, manual touch reduction, exception rate, ingestion accuracy, benefit configuration quality, encounter completeness, and downstream denial or rejection trends.
• Builds strong relationships with senior leaders and stakeholders to align product strategy with business priorities.
• Resolves competing priorities through data-driven decision making and stakeholder alignment.
• Monitors post-launch performance and continuously iterates based on customer feedback, operational metrics, and compliance needs.
• Maintains deep knowledge of healthcare payer operations, eligibility, benefits, compliance, and encounter management.
• Engages customers, operations, compliance, engineering, data teams, and client-facing partners to identify pain points and opportunities.
• Conducts market research, competitive analysis, and customer discovery to identify product opportunities.
• Translates complex healthcare workflows, regulatory requirements, contractual obligations, and operational challenges into scalable product capabilities.
• Leads user research initiatives and incorporates findings into discovery, prioritization, roadmap planning, and solution design.
• Champions customer-centric product development while mentoring Product Managers on customer-focused practices.
• Supports development of user personas based on operational workflows and stakeholder needs.
• Partners with design, engineering, and operations teams to deliver intuitive user experiences that simplify complex eligibility, benefit, and encounter workflows.
• Reduces user friction while increasing adoption of automation capabilities.
• Leads ideation of automation-first and AI-enabled product solutions.
• Evaluates tradeoffs across workflow design, automation, compliance, data quality, implementation complexity, and long-term maintainability.
• Ensures solutions balance business value, technical feasibility, operational adoption, and measurable outcomes.
• Creates and maintains the product backlog, including epics, features, and user stories.
• Prioritizes work aligned to business objectives and customer value.
• Defines requirements for data ingestion, business rules, validation, audit trails, operational reporting, and exception handling.
• Develops clear, testable, outcome-focused requirements.
• Develops strategic roadmaps informed by customer insights, healthcare industry trends, operational priorities, and enterprise strategy.
• Drives Agile product development through backlog refinement, sprint planning, reviews, and prioritization.
• Collaborates with engineering, architecture, compliance, design, data, and business stakeholders throughout delivery.
• Develops go-to-market strategies aligned with customer needs, market opportunities, operational readiness, and business goals.
• Aligns cross-functional teams around shared product strategy and organizational priorities.
• Builds consensus across engineering, architecture, compliance, operations, data, and business teams.
• Identifies opportunities to improve product practices, automation outcomes, operational processes, and stakeholder engagement.
• Identifies strategic risks related to compliance, eligibility accuracy, benefit configuration, encounter quality, auditability, and operational performance.

Requirements

• Bachelor’s degree required.
• Ten (10) plus years of product management, enterprise product management, healthcare technology product management, or related experience.
• Healthcare technology experience required; eligibility and benefits, payer operations, Medicaid, Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
• Demonstrated experience delivering automation-first, AI-enabled, rules-based, workflow, platform, or data-ingestion solutions.
• Experience partnering with engineering, architecture, compliance, operations, data, and business stakeholders in a technical product organization.
• Experience with JIRA, Confluence, Figma, Aha!, Amplitude, Tableau, or similar product management, analytics, and design tools required.
• Marketing experience preferred.
• Scrum/Agile certification preferred.
• Or equivalent combination of education and/or experience.
• Strong analytical skills with experience evaluating products, markets, competitors, customer needs, and operational performance.
• Strong understanding of eligibility, benefits, plan configuration, authorization, service rules, operational workflows, compliance, and downstream encounter quality.
• Ability to translate complex healthcare business rules, regulatory requirements, and operational processes into scalable product capabilities.
• Demonstrated ability to use data to identify automation opportunities, define measurable outcomes, and improve operational performance.
• Comprehensive understanding of Agile methodologies.
• Excellent collaboration, interpersonal, presentation, and stakeholder management skills.
• Proven ability to prioritize complex product functionality and solve problems with minimal supervision.
• Exceptional written and verbal communication skills.
• Ability to work effectively with geographically distributed teams.
• Ability to decompose complex capabilities into epics, features, user stories, and acceptance criteria.
• Proficiency with Microsoft Office applications.
• Strong ownership, strategic thinking, critical thinking, planning, scheduling, and project management skills.
• Experience conducting market research, gathering customer insights, and interpreting product, operational, and market analytics.
• Strong technical acumen with the ability to collaborate effectively with engineering, architecture, and data teams.
• Financial acumen with an understanding of business value, cost drivers, and financial impacts of product decisions.
• Strong understanding of user experience principles and customer-centered product design.
• Adaptability in rapidly changing business, regulatory, and operational environments.
• High emotional intelligence and the ability to build trust and influence across cross-functional teams.

Tech Stack

• Tableau

Benefits

• Medical, Dental, and Vision insurance
• Employer Paid Basic Life Insurance and AD&D
• Voluntary Life Insurance (Employee/Spouse/Child)
• Health Care and Dependent Care Flexible Spending Accounts
• Pre-Tax and Post --Tax Commuter and Parking Benefits
• 401(k) Retirement Savings Plan with Company Match
• Paid Time Off
• Paid Parental Leave
• Short-Term and Long-Term Disability
• Tuition Reimbursement
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)