Senior Product Manager, Value-Based Care Platforms

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

📋 Description

• Take charge of the overall direction of a designated product area from start to finish.

• Bridge the gap between clinical, operations, finance, provider relations, and payer-facing teams with Software Engineering.

• Conduct discovery processes, establish and prioritize the roadmap, shape and prioritize the backlog, write requirements with measurable acceptance criteria, and approve completed work.

• Gather and document requirements through interviews, workshops, and observation.

• Create current-state and future-state workflows in Lucid using swimlane/BPMN techniques.

• Develop user stories, business rules, edge cases, and maintain requirements traceability, data dictionaries, and process documentation.

• Design mockups and interactive Figma prototypes while applying design-thinking methodologies.

• Analyze claims, eligibility, encounters, HCC/risk adjustment, HEDIS/quality gaps, and payer files.

• Write SQL queries to analyze data, validate assumptions, and verify feature results.

• Assist with payer, EMR, and vendor integrations by documenting file specifications, interfaces, and data flows.

• Act as the primary liaison between business users and engineers on a daily basis.

• Collaborate with QA on test scenarios and coordinate User Acceptance Testing (UAT) with business stakeholders.

• Facilitate feature adoption through walkthroughs, release notes, job aids, training, and change management.

• Oversee go-to-market strategies for releases and manage launch communications.

• Maintain a well-organized, sized, sequenced, and sprint-ready roadmap and backlog.

• Prioritize tasks based on business value, regulatory/payer deadlines, effort, and dependencies.

• Lead sprint planning, backlog refinement, and sprint reviews; accept or return completed stories based on acceptance criteria.

• Define success metrics and product KPIs, report on adoption and outcomes, and incorporate results into the roadmap.

• Align the roadmap with company OKRs and Technology strategy.

• Manage JIRA comprehensively, including backlog, epics, sprints, reporting, velocity, burndown, and status tracking.

• Coordinate with engineering, data, QA, vendors, and payers to manage dependencies, timelines, and hand-offs.

⛳️ Requirements

• 5+ years of experience in product management, product ownership, or senior product/business analysis in software or data projects, including writing user stories and acceptance criteria in an Agile/Scrum environment.

• 5+ years of experience in the healthcare industry with a health plan, MSO, ACO, value-based care organization, provider group, or healthcare technology company.

• Practical knowledge of Medicare Advantage and value-based care models.

• Understanding of risk adjustment (HCCs/RAF), quality programs (HEDIS, CMS Star Ratings), and claims, eligibility, and encounter data.

• Familiarity with X12 EDI transactions (834, 835, 837).

• Proficient SQL skills for querying and validating data.

• Bachelor's degree in business, health administration, information systems, or a related field, or equivalent experience.

• Proven ability to map complex workflows and communicate them clearly to both business and technical audiences.

• Strong written communication skills; requirements should be clear enough to build from without needing a meeting.

• Experience managing a backlog and roadmap in Jira, Azure DevOps, or a similar platform.

• Proficient in Agile/Scrum methodologies and JIRA management, including backlog, epics, sprints, boards, and reporting.

• Experience in defining and tracking product KPIs and success metrics.

• Preferred: experience in Florida's Medicare Advantage market.

• Preferred: previous experience as a product manager or product owner, including ownership of the roadmap and backlog prioritization.

• Preferred: CBAP, CCBA, PMI-PBA, or CSPO certification.

• Preferred: familiarity with data warehouses, BI tools, and FHIR or HL7 interfaces.

• Preferred: hands-on experience with Lucid or Visio and Figma.

• Preferred: experience in design-thinking/human-centered design practices and linking product work to company OKRs.

🏝️ Benefits

• Health, dental, and vision insurance.

• 401(k) plan.

• Paid time off.

• Company holidays.

• Opportunity to influence the future of healthcare technology within a rapidly expanding value-based care organization.