Senior Product Manager, HIE, AI Suspecting, and Care Gap Management

Reveleer

15d•$140,000 - $160,000•Remote

About The Position

Reveleer is hiring a Senior Product Manager to lead the HIE & AI Suspecting and Care Gap Manager domains within its Clinical Intelligence Suite of value-based care solutions. The role connects clinical data retrieval, AI-driven identification of diagnosis and quality opportunities, care-gap delivery, evidence submission, and gap closure into a unified workflow for health plans and provider groups. The Senior Product Manager defines and communicates a multi-year vision and roadmap across two product pods, balancing pod-level and platform-level investments and aligning with Reveleer’s Prospective workflows. The position combines product strategy, vendor management, regulatory tracking, and provider-facing workflow design. It also serves as the internal subject matter expert on health information exchanges (HIEs), their structures and regulatory environment, as well as Care Gap Manager configuration, provider workflows, and incentive programs. The role works closely with engineering, clinical, data, compliance, legal, product marketing, customer support, vendors, and executive stakeholders. It owns HIE vendor relationships and portfolio strategy, monitors regulatory developments affecting data access and exchange, guides product alignment with HIPAA and HITRUST requirements, and communicates progress, risks, and roadmap decisions to leadership.

Requirements

Six or more years of product management experience, including at least three to four years in healthcare data, health IT, or interoperability, and a record of owning a roadmap spanning multiple teams or products.
Demonstrated experience defining product vision and strategy across multiple teams or products and aligning engineering, clinical, and executive leaders.
Direct experience working with or negotiating with HIEs, health information networks, or clinical data exchange vendors.
Working knowledge of healthcare interoperability standards, including HL7, FHIR, and C-CDA, and how unstructured clinical data moves between systems.
Familiarity with regulations governing health information exchange, including information blocking rules and TEFCA.
Working knowledge of HEDIS, CMS Stars, risk adjustment, RAF scoring, and HCCs, including how health plans manage quality and risk gaps and how provider groups close them.
Experience owning B2B SaaS products with multiple user types, such as health plan administrators and provider-facing portals, and configuration-driven workflows.
Strong vendor management skills, including contract negotiation, relationship management, and escalation handling.
Strong communication skills and experience working cross-functionally on product development and influencing internal and external stakeholders, including customers.
Comfort serving as an internal expert on a technical and regulatory subject area and presenting to non-technical stakeholders and executive leadership.
Ability to influence without direct authority across pods and mentor product managers and analysts.
Experience with AI-driven suspecting, coding, or diagnosis capture in a Medicare Advantage or value-based care setting.
An AI-native product management mindset, using AI as a tool and guiding the evolution of the product domains and broader platform.

Nice To Haves

Prior experience at a payer, health system, or HIE.
Experience with care-gap closure, supplemental data submission, or provider engagement platforms for health plans, including incentive program display and omni-channel outreach.
Experience across more than one line of business, such as Medicare Advantage, Medicaid managed care, FEP, and Commercial or ACA exchange.
Familiarity with HIPAA and HITRUST requirements for multi-tenant SaaS products that handle PHI.

Responsibilities

Define and communicate a multi-year product vision unifying the HIE & AI Suspecting and Care Gap Manager pods into one workflow for health plans and provider groups.
Sequence investments across both pods, prioritize the combined roadmap, make pod-level and platform-level trade-offs explicit, and align with Reveleer Prospective workflows.
Define and prioritize roadmaps based on customer and internal operations needs, data retrieval performance, AI suspecting accuracy, Care Gap Manager adoption, and gap-closure outcomes.
Represent product in agile ceremonies for both pods, including standups, backlog refinement, sprint planning, product management meetings, and retrospectives.
Partner with engineering and clinical teams to translate HIE, health plan, and provider requirements into product requirements and maintain PRDs for new features.
Set and track success metrics for retrieval coverage, data completeness, suspecting accuracy, gap closure, evidence validation turnaround, provider activation, and provider satisfaction.
Own product documentation and work with product leaders and Product Marketing to train internal teams on HIE knowledge and product capabilities.
Manage commercial and technical relationships with HIE vendors and network partners, including onboarding, renewals, and issue escalation.
Negotiate data access terms and service levels, serve as the primary product and integration contact for HIE partners, and set the multi-year HIE portfolio strategy.
Track federal and state regulations affecting HIE data access, including information blocking rules, TEFCA, and state-level requirements, and inform internal stakeholders of their implications.
Maintain knowledge of the national and regional HIE landscape, including geographic coverage, data formats, access models, new exchanges, and consolidations.
Investigate reported issues, prioritize engineering support as appropriate, and communicate resolutions to customer support where appropriate.
Partner with Compliance and Legal to shape processes and policies for triaging and reporting PHI-related issues and managing adherence to those policies.
Partner with Compliance and Legal to keep Care Gap Manager aligned with HIPAA and HITRUST requirements, including multi-tenant customer data segregation and audit-ready evidence logging.
Coordinate with adjacent pods and teams, including Hybrid AI, Point of Care, Data Engineering, and Prospective Workflows, to align roadmaps and shared dependencies.
Communicate roadmap, vendor status, regulatory risk, and progress against the unified vision to leadership on a regular cadence.
Work with data engineering to prioritize HIE connections and data types that improve coverage and accuracy, and identify shared data foundations for AI suspecting and Care Gap Manager.