Senior Product Manager, Eligibility & Coverage
About The Position
Own the strategy and roadmap for products hospitals and health systems use to verify patient insurance eligibility, discover undisclosed coverage, and understand patients’ benefits. Independently guide an engineering team of roughly 3–8 engineers and act as a primary point of contact for health-system customers on eligibility and coverage questions. The role owns eligibility verification, coverage discovery, benefits summarization and interpretation, payer connectivity, and data-source capabilities. It uses market research, data analysis, and product-performance analytics to identify customer needs and trends, shape the long-term roadmap, build business cases, and improve coverage discovery accuracy. The product manager leads delivery and quality decisions, partners with engineering and design leadership on integration trade-offs, and explores responsible uses of AI in product development and the product itself. The role leads customer meetings, presents the roadmap, gathers feedback, and negotiates competing requests. It manages relationships across engineering, compliance, payer operations, health-system customers, and payer partners, applying healthcare regulatory knowledge to manage compliance and risk. The position is hybrid and requires residence in or near a designated collaboration hub: Costa Mesa, San Jose, Allen, Austin, Franklin, New York City, Schaumburg, Washington, D.C., Atlanta, Boston, or Seattle. The role reports to the Sr. Director of Eligibility & Coverage.
Requirements
- At least 5 years of product management experience, including end-to-end ownership of a product area.
- Experience in healthcare IT, revenue cycle management, or health insurance/payer operations.
- Experience independently guiding an engineering team of roughly 3–8 engineers and owning a product roadmap.
- Experience using data analysis, including AI-assisted analysis, to validate assumptions and prioritize product decisions.
- Experience leading customer-facing meetings, presenting roadmaps, and negotiating scope with external stakeholders.
- Hands-on experience with AI tools including chat-based assistants, agentic tools, and developer-integrated or prototyping tools.
- Familiarity with healthcare regulatory and data-protection requirements, such as HIPAA and EDI standards.
- Reside in or near one of the designated collaboration hubs.
Nice To Haves
- Direct experience with patient eligibility verification, including 270/271 EDI transactions, or coverage discovery is strongly preferred.
Responsibilities
- Own the strategy and roadmap for eligibility verification, coverage discovery, benefits summarization and interpretation, payer connectivity, and data-source products.
- Conduct market research and data analysis to identify customer needs and trends, shape the long-term roadmap, and develop business cases for initiatives such as expanding payer coverage or adding data sources.
- Monitor product and payer-response performance and use analytics, including AI-accelerated analysis, to identify incomplete, ambiguous, or incorrect eligibility responses and assess data-source accuracy.
- Independently guide an engineering team of roughly 3–8 engineers and own delivery and quality decisions.
- Partner with engineering and design leadership to resolve trade-offs in integrating payer connections and eligibility data sources.
- Use agentic AI and developer-integrated tools to accelerate discovery, requirements, and prototyping, and identify responsible opportunities to embed AI in the product.
- Lead customer meetings, present the roadmap, gather feedback, and negotiate competing requests in support of product strategy.
- Manage relationships across engineering, compliance, payer operations, health-system customers, and payer partners.
- Apply healthcare regulatory knowledge to manage compliance and risk.
Benefits
- Great compensation package and bonus plan.
- Medical, dental, and vision benefits.
- 401(k) matching.
- Flexible work environment with the ability to work remotely, hybrid, or in-office.
- Flexible time off, including volunteer time off, vacation, sick time, and 12 paid holidays.
- Variable pay opportunity.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
