Product Owner

Role Overview

Lead Product Owner / Business Integration Lead for a Healthcare Payer organization. You will lead a high-priority task force focused on correcting end-to-end failures in the medical prior authorization workflow, ensuring successful flow of authorizations into the claims platform.

Key Responsibilities

• Lead a cross-functional task force to identify and implement corrective actions across the end-to-end prior authorization process.
• Drive solutions across functional silos, including Claims, IT, and Clinical teams.
• Oversee extraction of medical prior authorizations from Guided Care and loading them into the Facets claims platform.
• Negotiate deliverables and solution options with claims teams to accelerate resolution of matching errors.
• Manage day-to-day Product Owner activities, including Jira workflows and leadership/executive presentations.

Required Qualifications

• 15 years of experience in the Healthcare Payer or Healthcare Delivery industry.
• 8–10 years experience as a Product Owner.
• Strong working knowledge of the Facets claims platform, especially claims-to-auth matching logic.
• Experience with Guided Care (UI and/or extraction processes).
• Deep subject matter expertise in Prior Authorizations and the 278 transaction set.
• Ability to work a standard workday in Eastern Standard Time (EST).

Preferred Qualifications

• Proficiency in Jira and PowerPoint for tracking and executive reporting.
• Prior experience in task force or rapid corrective action environments.