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Product Owner (Utilization Management / Prior Authorization)

Mindlance

Baltimore, MD(remote)

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JOB DETAILS
SKILLS
Access Authorization, Agile Programming Methodologies, Analysis Skills, Backlog Prioritization, Business Analysis, Business Development, Certified Scrum Product Owner, Change Control, Communication Skills, Continuous Improvement, Cross-Functional, Customer Satisfaction, Customer Support/Service, Establish Priorities, Functional Testing, Healthcare, Implants, Information Technology & Information Systems, Leadership, Market Research, Metrics, Performance Management, Performance Metrics, Pricing, Process Improvement, Product Backlog, Product Development, Product Engineering, Product Management, Product Planning, Product Reviews, Project/Program Management, Regulatory Compliance, Regulatory Requirements, Reporting Skills, Requirements Management, Resource Utilization, Sales Training, Scrum Product Owner, Sprint Planning, Staff Requirements, Strategic Planning, Systems Analysis, Technical/Engineering Design, Test Requirements, Testing, Time Management, Utilization Management
LOCATION
Baltimore, MD
POSTED
23 days ago
100% Remote

Note from HM:
We re seeking a Business Integration Lead with strong Healthcare integration experience to drive complex, cross functional initiatives. This role leads program execution, aligns stakeholders, and ensures measurable improvements in PA performance, provider experience, and operational efficiency.

Key Responsibilities
Lead end to end delivery of PA (Prior Authorization) programs across clinical, technical, and operational teams
Translate PA (Prior Authorization) strategy into actionable roadmaps and coordinated workstreams
Partner with clinical leaders to optimize review workflows and regulatory compliance
Monitor KPIs (TAT, auto decision rates, denials, provider friction) and lead continuous improvement

Qualifications
15+ years in healthcare delivery, payer operations, UM (Utilization Management), or PA (Prior Authorization) programs
Proven experience leading large, multi workstream initiatives
Strong understanding of PA workflows, UM criteria, and regulatory requirements
Experience with PA technology, automation, and EHR/interop standards
Excellent communication, stakeholder management, and executive level reporting skills

PURPOSE:
Serves as an authority over Product Owners and product teams to ensure clarity in strategic direction. Brings an expertise to lead and manage project requirements and introduces new, beneficial tools and practices. Focuses on managing the development of products to meet the needs of internal and external clients, and helps to establish the business value for their development and implementation. Provides business point of view and guidance on opportunities and risks to support clients.

ESSENTIAL FUNCTIONS:
20% Leads the development of the product portfolio and provides workable solutions to satisfy customer and market expectations in close collaboration with stakeholders, Product Owners, and scrum teams.
15% Collaborates with management to identify and plan product releases by reviewing milestones with stakeholders; manages the continual development of existing products.
15% Validates proposed solutions by performing market research to gain insights and inform; assists with pricing packages and structures.
10% Communicates internally and externally, develops and maintains Product Roadmap(s).
10% Manages Product Backlog(s) for the development teams by using product road mapping and backlog management tools.
10% Works closely with testing managers to ensure product functionality is properly tested against business requirements; leads change control processes to reflect project priorities.
5% Aides in the development process by attending product refinement, sprint planning, and sprint reviews.
5% Coordinates and organizes workshops with product users using the Client and define approach; validates hypotheses and implements best solutions.
5% Contributes to wider initiatives and activities that support and increase customer satisfaction.
5% Conducts product training to partners, staff, and identifies need for individual/team training opportunities.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level: Bachelor's Degree
Education Details: Product Management, Engineering, Information Technology or related field
Experience: 8 years experience business analysis, business development, solutions development, system analysis, technical design/development implantation or equivalent experience OR
6 years Previous product owner experience with an in-depth knowledge of agile process and principles.

In Lieu of Education
In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Preferred Qualifications
Previous healthcare experience
Advanced degree

Knowledge, Skills and Abilities (KSAs)
Proficient in Agile methodologies, principles, and procedures., Expert
Ability to use Product KPIs and business metrics to optimize the product., Expert
Ability to recognize, analyze, and solve a variety of problems., Expert
Ability to analyze, organize and prioritize work while meeting multiple deadlines., Expert
The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Licenses/Certifications
Certified Scrum Product Owner PO certification Upon Hire Req

EEO:
Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

About the Company

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Mindlance

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