Product Manager

VySystems is seeking a Product Manager to define and own the product vision and multi-year roadmap for Payment Integrity products. The role involves leading cross-functional teams to deliver scalable solutions while ensuring compliance with regulatory requirements and optimizing product performance through KPIs.

Responsibilities:

• Define and own the end to end product vision and multi year roadmap for Payment Integrity products (pre payment, post payment, claims analytics, audit workflows, rules engines, etc.)
• Identify market, regulatory, and industry trends to shape strategic product decisions
• Develop business cases, cost–benefit analyses, and value propositions for new capabilities
• Lead cross functional teams (engineering, data science, claims operations, finance) to deliver scalable Payment Integrity solutions
• Translate business needs into actionable product requirements, user stories, and acceptance criteria
• Prioritize the product backlog using a data driven approach while balancing long term strategy and short term wins
• Drive iteration planning, sprint reviews, and release cycles with engineering
• Ensure solutions reduce payment leakage, improve claims accuracy, and support audit effectiveness
• Partner with finance and operations to track product performance through KPIs such as overpayment recovery rate, detection yield, cost avoidance, and operational efficiency
• Continuously optimize rules engines, fraud/waste/abuse detection algorithms, and workflow systems
• Work closely with internal teams (Compliance, Legal, Provider Management, Medical Policy) to ensure solutions meet regulatory and audit requirements
• Partner with external vendors, payment integrity service providers, and technology partners
• Communicate product vision, updates, and performance metrics to senior leadership
• Advocate for intuitive user experiences for auditors, analysts, clinicians, and claims processors
• Ensure robust product documentation, training materials, and operational readiness
• Drive continuous improvement by collecting user feedback and monitoring adoption

Requirements:

• 6+ years of product management experience, preferably in healthcare, insurance, payment integrity, claims processing, or fintech risk & controls
• Strong understanding of claims lifecycle, reimbursement methodologies, pre payment edits, post payment audits, and fraud/waste/abuse detection
• Experience working with engineering, analytics, and data science teams
• Proficient with data analysis, KPI development, and financial impact modeling
• Exceptional communication, stakeholder management, and leadership skills
• Ability to prioritize in a fast paced environment with competing demands
• Experience with payment integrity platforms, claims adjudication systems, workflow tools, or rules engines
• Background in healthcare regulations (CMS, Medicare/Medicaid guidelines, ICD/CPT coding)
• Exposure to machine learning based anomaly detection or predictive models
• Product certifications (CSPO, Pragmatic PM, AIPMM, etc.)
• MBA or equivalent experience in strategy-heavy roles