Medicare Claims Technology Product Management Director

This is a fully remote position, open to applicants in Connecticut, +3 more states.

📋 Description

• Define the strategy, roadmap, performance, and modernization of technology products and platforms that support Medicare claims management for over 4 million members.

• Develop and enhance product structures, practices, responsibilities, and collaborative workflows within a product operating model.

• Collaborate with business units, engineering, data teams, architecture, operations, delivery leaders, and strategic software partners to translate requirements into prioritized investments, aligned roadmaps, and measurable results.

• Influence partner roadmaps, align modernization efforts, manage essential dependencies, collaborate with release management on complex releases, and ensure partners are accountable for product performance and business results.

• Guide and mentor product management colleagues, fostering accountability for product and business outcomes within teams.

• Articulate and promote product vision, strategy, roadmaps, investment priorities, business cases, Epics, initiatives, OKRs, backlogs, capacity, timelines, and commitments.

• Lead discovery initiatives, define roadmap items and epics, identify dependencies, estimate future-quarter work, and facilitate product ceremonies and PI planning.

• Track product, technical, and customer health using performance metrics and quantitative insights.

• Organize product launches, beta testing, user feedback collection, and product documentation.

• Facilitate the cross-functional product leadership team and share business strategies and outcomes.

• Present product team achievements and final deliverables to stakeholders.

• Recruit, develop, and coach product management colleagues while fostering high-performing team standards and a customer-focused culture.

⛳️ Requirements

• A minimum of 10 years of relevant experience in digital product management, healthcare technology, claims administration, or similar product and technology leadership roles.

• At least 7 years of experience in software product management, with responsibility for product strategy and the complete product lifecycle from discovery to launch, adoption, and continuous optimization.

• Over 5 years of experience in the healthcare payer sector, with substantial involvement in claims administration products, platforms, operations, or transformation projects.

• Proven understanding of the complete claims lifecycle, including benefit interpretation, adjudication, pricing, payment, adjustments, appeals, and financial reconciliation.

• Experience in leading, developing, and mentoring product management teams.

• Ability to primarily work during Eastern Time business hours and address critical business or production needs when necessary.

• Familiarity with Medicare Advantage claims, including CMS requirements, benefit configuration, provider reimbursement, claims accuracy, payment integrity, and regulatory compliance.

• Capacity to translate claims business rules, regulatory requirements, operational needs, and performance challenges into product capabilities, roadmaps, and quantifiable outcomes.

• Experience collaborating across Claims Operations, Configuration, Provider, Finance, Compliance, Clinical, Engineering, and Data teams.

• Proven track record in leading large-scale technology modernization efforts involving cloud-based platforms, microservices architectures, legacy system transformations, and complex enterprise dependencies.

• Ability to influence senior business and technology leaders, align cross-functional teams, and steer prioritization and investment decisions within a complex, regulated environment.

• Experience in managing strategic technology vendor relationships.

• Background in leading product or operating model transformations within a large, matrixed organization.

• Demonstrated ability to utilize data, quantitative analysis, and product performance metrics.

• Working knowledge of cloud platforms, modern software architectures, artificial intelligence, and machine learning.

• Product management or Agile certifications.

• Bachelor’s degree or equivalent professional experience.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Target award in the company’s equity award program.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.