Product Manager, Authorizations (Remote)

Availity is a leading healthcare technology company focused on delivering revenue cycle and related business solutions for healthcare professionals. They are seeking a Product Manager with expertise in prior authorization workflows and interoperability to implement solutions that streamline processes while ensuring compliance with regulatory guidelines.

Responsibilities:

• 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

Requirements:

• Have a minimum of 5 years' experience in Product Management preferably with client facing experience within healthcare technology
• Deep expertise in prior authorizations workflows. This is required to be considered for the role
• 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, the 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
• Product background highly preferred
• Proficiency in analyzing data and finding actionable insights
• Experience with AI-driven utilization management solutions and automation technologies
• Knowledge of the full revenue cycle is a plus