Roles and Responsibilities: 1. Product Strategy and Vision

Define and drive product strategy for CAS integration focusing on enrollment, claims, and payment functions.

Align product vision with organizational objectives and regulatory requirements (HIPAA, CMS).

Conduct market and competitor analysis to inform product direction and enhancements.

Identify opportunities for innovation and process optimization within payer workflows.

2. Stakeholder Management

Serve as a key liaison between business, IT teams, and external vendors to align integration goals.

Facilitate communication between stakeholders to define product requirements and share updates.

3. Requirements Gathering and Analysis

Work with business analysts, product owners, and architects to gather, analyze, and document requirements.

Prioritize product features based on business needs, customer feedback, and technical feasibility.

4. Roadmap and Agile Execution

Lead PI (Program Increment) planning sessions in accordance with SAFe (Scaled Agile Framework).

Develop and maintain product roadmaps aligned with Agile delivery cycles and integration milestones.

Collaborate with project managers to track progress, allocate resources, and resolve dependencies.

5. Cross-Functional Collaboration

Partner with technical teams to design and implement integration solutions.

Support QA teams in test planning and performance validation of integrated systems.

6. Compliance and Risk Management

Ensure all integration solutions comply with regulatory standards like HIPAA.

Regularly report on performance, risk, and compliance metrics to stakeholders.

Must-Have Skills:

5+ years of experience in product management or business analysis in the US Healthcare payer domain.

Strong domain expertise in Core Administration Systems, specifically in enrollment, claims, and payments.

Knowledge of EDI, HL7, and API integration standards.

Hands-on experience with Agile methodologies and SAFe framework.

Strong communication and stakeholder management skills.

Proven experience in roadmap planning, PI planning, and requirements documentation.

Deep understanding of healthcare regulations including HIPAA.

Good-to-Have Skills:

Experience with specific Core Admin platforms like Facets, QNXT, HealthRules.

Master’s degree in Healthcare Management, Business Administration, or Information Technology.

Familiarity with CMS compliance guidelines.

Ability to manage multiple concurrent projects in a fast-paced environment.

Proficiency in tools like JIRA, Confluence, and Productboard.