Vice President, Product, Medical Cost Containment & Authorization (Remote)

Availity

1d•Remote

About The Position

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change. At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission. We're on a mission to bring the focus back to what truly matters – patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding. Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem. We are seeking a Vice President of Product, Medical Cost Containment & Authorization to lead the strategy, execution, and scale of our Utilization Management (UM) product portfolio during a pivotal moment of industry transformation. This VP will own an end‑to‑end product suite that blends AI‑driven decisioning, healthcare interoperability, and deep UM expertise, with a mandate to modernize and disrupt how utilization management is delivered across the healthcare ecosystem. This is a high‑impact, executive‑level role for a product leader who thrives in ambiguity, can operate as a peer to senior executives, and has the confidence to lead through scale, complexity, and change. Sponsorship, in any form, is not available for this position. Location: Remote, US Why you want to work on this team: Work on cutting-edge solutions that have the potential to reshape prior authorization processes across the healthcare industry. Engage in meaningful work that drives disruption, accountability, and positive change for payers and providers. Be part of a team that values innovation and collaboration, positioning Availity as a leader in interoperability and burden reduction.

Requirements

Bachelor’s degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred.
10+ years of experience in healthcare product management, medical management, or utilization management.
5+ years in a senior product leadership role.
Deep expertise in prior authorization, utilization review, and medical cost containment strategies.
Strong understanding of managed care, payer operations, and healthcare regulations.
Experience working with clinical teams and medical policy development.
Background in digital health, automation, or AI-enabled clinical workflows.
Proven success launching complex, regulated healthcare products at scale.
Strategic product leadership and executive-level communication.
Ability to translate clinical and regulatory complexity into usable products.
Strong analytical and financial acumen.
Collaborative leadership across clinical, technical, and business teams.
Comfort operating in highly regulated, fast-changing environments.

Nice To Haves

Proven track record in building AI products from incubation to scale
Experience disrupting an established healthcare workflow

Responsibilities

Product Strategy & Vision Defining and owning the long-term product vision and roadmap for medical cost containment and authorization capabilities.
Aligning product strategy with enterprise affordability, quality, and growth goals Identifying market trends, regulatory changes, and competitive.
opportunities impacting utilization management and authorization.
Product Development & Lifecycle Management Leading the end-to-end product lifecycle from concept through launch, optimization, and sunset.
Translating clinical, operational, and regulatory requirements into clear product requirements and prioritization.
Partnering with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions.
Ensuring products support evidence-based medicine, medical policy, and evolving clinical guidelines.
Medical Cost Containment & Authorization Overseeing products supporting prior authorization, concurrent review, retrospective review, and specialty management.
Driving innovation in automation, rules engines, AI-assisted review, and straight-through processing.
Balancing cost containment objectives with access to care, provider experience, and member satisfaction.
Cross-Functional Leadership Collaborating with stakeholders across products to ensure integrity and regulatory adherence.
Partnering with Leadership & Finance to quantify savings impact and ROI.
Supporting Sales and Client Management with product positioning, differentiation, and client engagement.
Governance, Compliance & Quality Ensuring products comply with federal and state regulations (e.g., CMS, NCQA, URAC, state DOI requirements).
Supporting audit readiness and accreditation standards related to utilization management.
Establishing KPIs and governance models to monitor product performance, outcomes, and quality.
Team Leadership Building, mentoring, and leading high-performing product management teams.
Fostering a culture of accountability, innovation, and continuous improvement.

Benefits

Availity is a certified “Great Place to Work”!
We have several Culture teams, a Young Professionals Group, and various ways to engage with fellow Availity associates
Availity is a culture of continuous learning.
We have many resources and experts in our tech stack and in our industry that can help get you there too!
Cool, you can wear jeans – we are a casual place.
We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!
We offer unlimited PTO for salaried associates + 9 paid holidays.
Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.
Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
Interested in furthering your education? We offer education reimbursement!
Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.
Want to work for an organization that gives back to the community? You’re at the right place!
Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.