Senior Product Manager, Healthcare Payer Strategy
About The Position
Oracle is seeking a Senior Product Manager to drive expansion of its healthcare claims adjudication platform into the United States market. The role is the product owner for U.S.-specific adjudication functionality, defining and delivering capabilities that address the business, operational, and regulatory requirements of the U.S. healthcare system. The product manager works with health plans, healthcare organizations, implementation teams, and internal stakeholders to understand market needs and translate them into requirements that guide development. The position enables engineering teams to build and deliver U.S. claims adjudication capabilities. It involves customer demonstrations, discovery of claims workflows, gathering requirements, documenting business rules, and developing functional specifications. The role connects customers and healthcare domain experts with engineering teams to ensure the resulting capabilities match market expectations and operational realities. The successful candidate brings knowledge of U.S. healthcare and fee-for-service claims adjudication, including claims intake, benefit determination, pricing, reimbursement methodologies, edits, payment calculation, and claims lifecycle management. This expertise will inform product strategy, roadmap priorities, and the platform’s ability to serve U.S. healthcare payers. U.S. citizenship is required, and the successful candidate must obtain and maintain a U.S. government security clearance after hire.
Requirements
- Deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes.
- Experience with healthcare payer operations, claims administration, claims adjudication systems, payment integrity, reimbursement, or related healthcare technology solutions.
- Experience in product management, business analysis, healthcare consulting, payer operations, or a related role.
- Proven ability to gather, document, and prioritize complex business and functional requirements.
- Strong customer-facing, presentation, and stakeholder management skills.
- Experience working directly with healthcare payers, health plans, third-party administrators, or healthcare technology vendors.
- Ability to translate complex claims processing requirements into software capabilities and functional solution designs.
- U.S. citizenship; the successful candidate must obtain and maintain a U.S. government security clearance after hire.
Nice To Haves
- Experience with commercial, Medicare, Medicaid, or government healthcare programs.
- Familiarity with healthcare claims standards and transactions, including X12 claims processing and related industry standards.
- Knowledge of value-based payment models and reimbursement methodologies, including Accountable Care Organizations (ACOs), bundled payments, shared savings arrangements, pay-for-performance programs, capitation, and other alternative payment models.
- Experience working in Agile software development environments.
- Knowledge of modern claims platforms, payment integrity solutions, utilization management systems, care management platforms, or core administration systems.
- Proven ability to use AI technologies to improve productivity, enhance decision-making, synthesize complex information, identify product opportunities, and strengthen collaboration across customers, product teams, and engineering organizations.
- Strong interest in emerging AI capabilities and a track record of evaluating and applying AI-driven approaches to solve business problems, improve operational efficiency, and drive innovation within healthcare technology environments.
Responsibilities
- Serve as the product domain expert for U.S. healthcare claims adjudication capabilities.
- Engage with prospective and existing customers to demonstrate product functionality and communicate the value of Oracle's claims adjudication platform.
- Conduct customer workshops, discovery sessions, and requirements-gathering activities to understand claims processing workflows, business rules, and operational challenges.
- Translate customer needs into product requirements, user stories, functional specifications, and other product management artifacts.
- Collaborate with engineering teams to define solution designs and clarify business requirements throughout the development lifecycle.
- Provide development teams with healthcare claims adjudication expertise and validate proposed solutions.
- Analyze market requirements and identify product enhancements needed to support U.S. healthcare payer operations.
- Contribute to product roadmap planning and prioritization for U.S.-specific capabilities.
- Partner with implementation, consulting, sales, and customer success teams to support customer adoption and successful deployments.
- Monitor industry trends, reimbursement models, and regulatory developments that may affect claims adjudication processes and product requirements.
- Advise internal stakeholders on U.S. healthcare claims processing and adjudication practices.
Benefits
- May be eligible for bonus and equity.
- Medical, dental, and vision insurance, including expert medical opinion.
- Short-term and long-term disability insurance.
- Life insurance and AD&D.
- Supplemental life insurance for employees, spouses, and children.
- Health care and dependent care Flexible Spending Accounts.
- Pre-tax commuter and parking benefits.
- 401(k) Savings and Investment Plan with company match.
- Flexible or accrued vacation, subject to employee eligibility and position.
- 11 paid holidays.
- Paid sick leave.
- Paid parental leave.
- Adoption assistance.
- Employee Stock Purchase Plan.
- Financial planning and group legal benefits.
- Voluntary auto, homeowner, and pet insurance.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
