Senior Product Manager - Fraud Waste & Abuse FWAJobs at CodoxoSenior Product Manager - Fraud Waste & Abuse FWA Your City Your State Category ProductType Full-timeMin. Experience ManagerPLEASE NOTE BEFORE APPLYINGCODOXO ISNOTABLE TO OFFER SPONSORSHIP OR ACCOMMODATE ANY CANDIDATES THAT ARE CURRENTLY BEING SPONSORED NOW OR IN THE FUTUREOf the 3.8T we spend on healthcare in the United States annually about a third of it is estimated to be lost due to waste fraud and abuse. Codoxo is the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud waste and abuse and ensure payment integrity. Codoxo helps clients manage costs across network management clinical care provider coding and billing payment integrity and special investigation units. Our software-as-a service applications are built on our proven Forensic AI Engine which uses patented AI-based technology to identify problems and suspicious behavior far faster and earlier than traditional techniques.We are venture backed by some of the top investors in the country with strong financials and remain one of the fastest growing healthcare AI companies in the industry.Position Summary We are looking for a Senior Product Manager to own the strategy roadmap and execution for our AI-powered FWA detection platform.This is a high-impact role at the intersection of healthcare domain expertise AIML-powered product innovation and SaaS product management. You will work directly with Special Investigations Units SIUs analysts clinical reviewers and payer leadership to deliver a product that helps customers detect emerging fraud schemes faster investigate more efficiently and recover more dollars.Beyond managing todays product we need a PM who can envision the future of FWA management in an agentic AI world where AI agents dont just surface alerts but autonomously triage leads gather evidence draft case narratives and collaborate with human investigators on the hardest decisions. You should have a strong point of view on how investigator workflows will fundamentally change over the next 2 to 3 years and how our platform should lead that transformation rather than react to it.We recognize that candidates who combine deep FWA domain experience with strong SaaS and ML product management skills are rare. Were open to strong candidates from either directionDomain-first candidates former SIU investigators analysts clinical reviewers or FWA payment integrity professionals who have moved into product and are eager to deepen their technical and ML product fluencyProduct-first candidates experienced B2B SaaS or MLAI product managers who can ramp quickly on the FWA domain with a demonstrated track record of learning complex regulated domains and partnering effectively with SMEsWhat we wont compromise on is curiosity rigor and the ability to bridge both worlds over time. You should be excited to spend time shadowing investigators and whiteboarding with data scientists about what an agentic future looks like.Key ResponsibilitiesOwn the product roadmap for the core FWA platform spanning AI-driven detection alerting case management and investigator workflowsShape the agentic AI vision for FWA by defining how autonomous and semi-autonomous agents will transform lead triage investigation evidence gathering and case documentation and build the roadmap to get there responsiblyLead customer discovery with SIU directors investigators data analysts nurse reviewers and medical directors going beyond surface-level requests to uncover generalizable workflow needsDefine product requirements across the FWA lifecycle lead generation alert triage investigation evidence building overpayment calculation provider education recoupment and law enforcement referralShape the AI-powered detection and investigation experience making critical product decisions about model explainability alert prioritization automation vs. human judgment and investigator-in-the-loop and eventually investigator-on-the-loop workflowsCollaborate with engineering and data science teams to deliver high-quality products providing the domain context they need to build effectively and reasoning about precisionrecall trade-offs in detection modelsPartner with FWA SMEs investigators and clinical reviewers to validate requirements test assumptions and stay ahead of emerging fraud schemes e.g. telehealth genetic testing DME including schemes that will themselves be powered by generative and agentic AIDrive go-to-market readiness working with sales marketing and implementation teams on positioning enablement and launchMake principled trade-off decisions by resisting one-off customization requests in favor of scalable configurable product solutions that serve the broader FWA marketEnsure compliance and defensibility by partnering with legal security and compliance to uphold HIPAA audit trail and evidentiary standards that investigators and law enforcement rely on including the unique governance challenges agentic systems introduceQualifications8 years of combined professional experience across some mix of Product Management FWA payment integrity claims auditing healthcare analytics or SaaSML product deliveryAt least 2 years in a Product Management role at a B2B SaaS or healthcare technology company with direct ownership of roadmap backlog and delivery working alongside engineering teams OR equivalent experience leading analytics investigative or operational teams where you owned the what to build decisions with technical partnersDemonstrated ability to learn complex regulated domains quickly. You can point to a time you went from novice to credible SME in a specialized areaStrong understanding of healthcare claims data Comfort working with AIML-powered products. You can reason about automation vs. human review trade-offs provide feedback on model outputs and design workflows where AI and human expertise complement each other. Familiarity with basic statistical concepts anomaly detection peer comparisons precisionrecall is expectedA forward-looking perspective on generative and agentic AI. You follow the space closely have opinions on where LLMs and AI agents are heading and can articulate concretely how they will reshape investigative and case management workflowsStrong customer discovery and stakeholder management skills. You can lead a conversation with a VP of SIU and a frontline investigator with equal confidence and translate what you learn into clear product directionA bias toward scalable product thinking. When a customer asks for a specific feature you instinctively ask whats the underlying need and look for the platform-level solutionHands-on operational experience in an SIU FWA analytics team or payment integrity function. Former investigators analysts nurse reviewers or SIU leads bring invaluable workflow intuitionWorking knowledge of healthcare FWA schemes upcoding unbundling phantom billing medically unnecessary services kickbacks and the end-to-end SIU workflowFamiliarity with healthcare coding and claims data ICD-10 CPTHCPCS NDC DRG modifiers NCCI edits LCDsNCDsUnderstanding of FWA regulatory frameworks HIPAA False Claims Act Anti-Kickback Statute NHCAA guidelines and OIGCMSMFCU referral processesUnderstanding of health plan IT ecosystems claims adjudication platforms EDI transactions 835837 and provider dataExperience shipping AIML-powered products where model outputs are reviewed or acted on by human usersHands-on experience designing products using LLMs RAG architectures or agentic AI frameworks tool use multi-step reasoning autonomous agentsDirect partnership with data science or ML engineering teams on model performance explainability and feedback loopsBackground in statistics data science or analytics formal or self-taughtExperience managing products at different lifecycle stages simultaneously sustaining a mature product while launching new capabilitiesTrack record of turning domain-specific insights into configurable platform-level product capabilitiesPhysical Requirements Work is performed in an office environment either in our office or work-from home and requires the ability to work on a computer operate standard office equipment and work at a desk.Accessibility Notice If you need reasonable accommodation for any part of the employment process due to a physical or mental disability please send an email to careerscodoxo.com with the subject Accommodation. Reasonable accommodation requests will be considered on a case-by-case basis.Benefits for YouHealth Dental and Vision insurance with 100 employee premium coverage Starts Day 1Unlimited PTOAnnual Professional Development stipendAnnual home office stipend401K Match after 90 daysWe are an Equal Opportunity EmployerCodoxo provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex