Artificial Intelligence (AI), Automation, Case Management, Data Analysis, Data Quality, Decision Support, Ecosystems, Establish Priorities, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Interoperability, Leadership, Patient Care Authorizations, Patient Safety, Performance Metrics, Product Management, Product Planning, Product Safety, Product Strategy, Regulatory Compliance, Reporting Dashboards, Risk, Technical Delivery, Technical Leadership, Use Cases, Utilization Management
JD:
Required Experience (Healthcare Focus)
• 10+ years of experience in technology product management or platform product roles
• Proven track record of delivering healthcare technology products end-to-end
• Direct experience with healthcare data, analytics, or AI-enabled solutions
• Hands-on experience operating within regulated environments (HIPAA, PHI, healthcare compliance)
• Demonstrated ability to lead complex healthcare programs amidst ambiguity and organizational change
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Healthcare Domain Expertise
• Strong understanding of healthcare operations and workflows across payer, provider, and care management ecosystems
• Familiarity with core healthcare domains, including:
o Utilization Management (UM)
o Care Management / Case Management
o Prior Authorization
• Ability to translate clinical and operational workflows into scalable digital solutions
• Deep understanding of regulatory, compliance, and patient safety considerations influencing product decisions
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Product Strategy & Execution
• Outcome-driven product mindset with a strong foundation in healthcare and data/AI-first thinking
• Ability to identify opportunities where data, analytics, and AI can improve outcomes and reduce administrative burden
• Ownership of product roadmap encompassing:
o Core healthcare capabilities
o Data and interoperability frameworks
o Analytics and AI enablement
• Strong prioritization skills based on clinical impact, operational value, technical feasibility, and risk
• Expertise in problem framing, with focus on insight generation, automation, and scalable solutions
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Data, Analytics & AI Enablement
• Working knowledge of healthcare data domains, including:
o Member, provider, clinical, authorization, and outcomes data
• Understanding of data flows across payer, provider, and partner ecosystems
• Experience collaborating with data engineering, analytics, and AI teams to:
o Enable reliable reporting and healthcare analytics
o Support data-driven decision making through insights and AI-powered summarization
• Experience defining product requirements for:
o Operational and clinical dashboards
o KPIs aligned to quality, cost, efficiency, and experience
o AI-enabled analytics (summarization, prioritization, decision support)
• Awareness of challenges related to data quality, lineage, interoperability, and adoption in healthcare environments
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AI & Automation in Healthcare
• Understanding of key AI use cases in healthcare, including:
o Clinical and operational summarization
o Decision support systems (human-in-the-loop)
• Ability to apply automation and AI to reduce manual effort, improve accuracy, and enhance care outcomes