Product Manager – Fraud, Waste & Abuse

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish the product strategy and roadmap.

• Create product market requirements documents that include prioritized features along with their justifications.

• Collaborate with external partners to evaluate partnership and licensing opportunities.

• Maintain expertise regarding competitors.

• Develop the core positioning and messaging for the product.

• Conduct product demonstrations for customers.

• Work together with the Marketing team to create sales tools.

• Suggest an overall budget to ensure successful outcomes.

• Provide brief training to the sales team during quarterly sales meetings.

• Serve as a leader within the organization.

• Partner with analytics and AI/ML teams to enhance product functionalities, including rules-based detection, provider scoring, and advanced data insights that reveal unusual billing patterns.

• Balance competing priorities among stakeholders, manage trade-offs, and guarantee alignment between strategic objectives and execution.

• Contribute to the advancement of integrated offerings (e.g., prepay and postpay solutions) to create a comprehensive, end-to-end fraud detection and payment integrity platform.

• Offer domain expertise in fraud, waste, and abuse workflows, covering provider investigations, case management, and recovery procedures.

• Recruit, develop, coach, lead, and retain top-tier talent, focusing on building and enhancing a team and culture that fosters best practices to support and drive high levels of satisfaction for both internal and external customers.

⛳️ Requirements

• Bachelor’s degree in Business, Computer Science, or another field demonstrating technical expertise.

• Prior experience in healthcare fraud, waste, and abuse (FWA) is preferred.

• 3-5+ years of experience in Product Management is required.

• Strong analytical and product management skills are essential, including a comprehensive understanding of how to interpret client business needs and convert them into application and operational requirements.

• Proven success in defining and launching web-based services and products.

• Exceptional verbal and written communication skills, with the ability to interact professionally with a diverse group including executives, managers, and subject matter experts.

• Experience with Kanban is preferred.

• Familiarity with AI and/or Machine Learning initiatives is preferred.

• Technical background with experience in software development.

• Demonstrated ability to influence cross-functional teams without formal authority.

• Proficient in Microsoft Excel, Microsoft Access, and database interaction capabilities.

• Experience with Medicare Advantage or other healthcare settings is preferred.

• Certification from the National Health Care Anti-Fraud Association as a Certified Accredited Health Care Fraud Investigator is preferred.

🏝️ Benefits

• Medical, dental, vision, disability, and life insurance coverage.

• 401(k) savings plans.

• Paid family leave.

• 9 paid holidays per year.

• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.