Senior Product Manager, Healthcare Automation- Eligibility & Benefits

Modivcare • Denver, CO

3d • $133,300 - $170,000

About The Position

Modivcare is seeking an experienced Senior Product Manager, Healthcare Automation- Eligibility & Benefits to lead the strategy, development, and execution of healthcare automation capabilities focused on eligibility, benefits, plan configuration, and the ingestion and management of plan and benefit information. This role involves partnering across various teams to deliver scalable, compliant, and automation-first solutions that improve member access, operational efficiency, downstream data quality, and overall business outcomes. The Senior Product Manager will own product vision and strategy, define and execute the product roadmap, establish automation strategies for eligibility and benefit workflows, and identify opportunities to leverage AI-enabled approaches. Performance will be measured through analytics evaluating product performance, user behavior, automation effectiveness, and operational workflows. Customer advocacy, user research, and market research are key components, requiring deep knowledge of healthcare payer operations. The role also involves user-centered design, solution ideation, requirements gathering, backlog refinement, prioritization, road mapping, agile delivery, go-to-market strategy development, cross-functional leadership, continuous improvement, and risk management related to compliance 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.
• Healthcare technology product management experience required; payer, Medicaid, Medicare Advantage, NEMT, eligibility, benefits, claims, encounters, authorization, or care access experience strongly preferred.
• Proven experience delivering automation, AI-enabled, workflow, rules-based, data-ingestion, or enterprise platform capabilities.
• 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.

Nice To Haves

• Healthcare technology experience required; eligibility and benefits, payer operations, Medicaid, Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
• Marketing experience preferred.
• Scrum/Agile certification preferred.
• Healthcare technology product management experience required; payer, Medicaid, Medicare Advantage, NEMT, eligibility, benefits, claims, encounters, authorization, or care access experience strongly preferred.

Responsibilities

• 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.
• Uses operational and product data to improve member access, ride decisioning, compliance readiness, and customer outcomes.
• Evaluates portfolio performance and identifies opportunities for continuous improvement.
• 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.
• Partners with engineering, architecture, and business subject matter experts to leverage rules engines, integrations, data pipelines, and configurable product capabilities.
• 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.
• Partners with engineering and architecture to ensure scalability, interoperability, compliance, and downstream system considerations are addressed.
• Develops clear, testable, outcome-focused requirements.
• Develops strategic roadmaps informed by customer insights, healthcare industry trends, operational priorities, and enterprise strategy.
• Prioritizes initiatives that improve automation, operational efficiency, compliance readiness, and customer value.
• Balances immediate operational needs with long-term platform modernization and scalability.
• Mentors Product Managers on roadmap planning and prioritization.
• Serves as a strategic partner for product-related planning and decision making across multiple products or product lines.
• Drives Agile product development through backlog refinement, sprint planning, reviews, and prioritization.
• Collaborates with engineering, architecture, compliance, design, data, and business stakeholders throughout delivery.
• Supports iterative delivery of automation-first and AI-enabled capabilities.
• Monitors delivery risks, dependencies, and scope tradeoffs while maintaining roadmap commitments.
• Develops go-to-market strategies aligned with customer needs, market opportunities, operational readiness, and business goals.
• Partners with marketing, operations, sales, customer success, and training teams to drive product adoption.
• Ensures implementation planning accounts for workflow changes, compliance considerations, customer impact, and adoption metrics.
• Uses post-launch feedback and operational performance to guide future product enhancements.
• Aligns cross-functional teams around shared product strategy and organizational priorities.
• Mentors Product Managers on collaboration and stakeholder engagement.
• 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.
• Ensures automation capabilities include appropriate controls, exception handling, reporting, and traceability.
• Partners across compliance, engineering, operations, data, and client teams to mitigate operational and regulatory risk.
• Develops comprehensive risk mitigation strategies.
• May lead projects and perform other duties as assigned.

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!)

What This Job Offers

• Job Type: Full-time
• Career Level: Senior