Product Manager - Healthcare

XChange Software Inc is seeking a Product Manager - Healthcare specializing in payer claims, AI testing, and adjudication. The role focuses on creating and validating datasets, claim scenarios, and adjudication outcomes while partnering with Product, Engineering, Claims Operations, and AI/ML teams to support AI governance and agent evaluation.

Responsibilities:

• Create golden datasets, claim scenarios, and test files for AI/agentic solutions
• Apply payer benefits, claims, prior authorization, and adjudication rules to determine expected outcomes
• Validate allow/deny decisions, member responsibility, and financial impacts with clear rationale
• Create and QA outputs in X12, JSON, and Excel
• Build edge cases, answer keys, and validation scenarios for AI/model testing
• Partner with Product, Engineering, Claims Operations, and AI/ML teams
• Support AI governance, agent evaluation, and standardized adjudication logic

Requirements:

• 5+ years in payer claims/product/testing
• strong healthcare payer knowledge
• hands-on claims adjudication
• structured-data/QA experience
• exposure to AI/ML or agentic AI