Senior IT Product Manager

Blue Cross & Blue Shield of Rhode Island • Providence, RI

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About The Position

The Senior IT Product Manager oversees the day-to-day implementation and enhancement of BCBSRI’s clinical integration and interoperability capabilities. The role manages CMS-0057 compliance initiatives, an Azure-based FHIR data ingestion pipeline, and bi-directional integration with EHR systems. Working closely with engineering, clinical, compliance, and external partners, the Product Manager delivers scalable, standards-based healthcare interoperability solutions.

Requirements

• 5+ years of product management experience in healthcare, health IT, or payer systems.
• Proven experience with CMS-0057, Da Vinci Implementation Guides (PAS, CRD, DTR), and healthcare compliance.
• Strong technical understanding of FHIR, HL7, USCDI, CCDA, and clinical data ingestion pipelines.
• Experience with Azure Health Data Services, Azure Functions (Node.js and C#), and Azure Data Factory.
• Demonstrated background integrating with EHR systems.
• Excellent communication and leadership skills with technical and clinical audiences.
• Ability to manage agile teams, prioritize backlogs, and deliver outcomes in cross-functional settings.

Nice To Haves

• Experience with payer-provider interoperability platforms, TEFCA, or care coordination tools.
• Knowledge of value-based care, risk adjustment (HCC coding), and HEDIS/STAR measure implications.

Responsibilities

• Drive the Clinical and Interoperability pod’s strategy and execution, focusing on compliance, scalability, and provider impact.
• Lead implementation of CMS-0057, including Provider Access APIs, Prior Authorization workflows (CRD, DTR, PAS), and Payer-to-Payer Data Exchange.
• Oversee clinical data ingestion using FHIR APIs via Azure Health Data Services, Azure Functions (Node.js and C#), and Azure Data Factory.
• Manage bi-directional EHR integration efforts using FHIR, HL7v2, and other healthcare data standards.
• Ensure interoperability components align with Azure-native architecture and HIPAA compliance requirements.
• Work with internal Data Governance teams on data lineage, metadata, and data quality initiatives.
• Translate clinical and technical requirements into product specifications for development teams.
• Collaborate with EHR vendors and provider partners to streamline data exchange and onboarding.
• Work with the Risk Adjustment Team and Quality Gap stakeholders to ensure FHIR clinical data flows as expected and supports HCC risk scores and care gaps.
• Maintain and build processes and controls around existing EMR ecosystems and govern them accordingly.
• Engage payer, provider, and technical stakeholders to drive adoption and usage.
• Stay informed about regulatory changes, FHIR enhancements, and interoperability trends such as TEFCA and USCDI+.

Benefits

• Flexible work arrangements, including remote and hybrid opportunities.
• Paid time off, including additional paid time to volunteer.
• Tuition reimbursement and student-loan repayment assistance.
• Health, dental, and vision insurance.
• Programs supporting mental health and well-being.
• Bonuses and investment plans.
• Employee growth and development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed