Senior Product Manager - Claims

Job Summary:

• The Senior Product Manager for Claims is responsible for the strategy, roadmap, and execution of product initiatives related to claims processing, payment, and related systems within Highmark.
• This role requires a deep understanding of healthcare claims, strong analytical skills, and the ability to collaborate effectively with engineering, operations, and business stakeholders. The Senior Product Manager will identify opportunities to improve efficiency, reduce costs, and enhance the overall claims experience for members and providers.

Essential Responsibilities:

• Product Strategy and Roadmap: Develop and maintain a comprehensive product strategy and roadmap for claims-related products, aligned with Highmark's overall strategic goals.
• Market Research and Analysis: Conduct market research, analyze industry trends, and monitor competitor activities to identify opportunities for product innovation and differentiation.
• Requirements Gathering and Prioritization: Gather and prioritize product requirements from internal and external stakeholders, translating them into clear and actionable user stories and specifications.
• Product Development and Launch: Collaborate with engineering, design, and other cross-functional teams to develop and launch new claims-related products and features, ensuring timely delivery and high quality.
• Product Performance Monitoring and Optimization: Monitor product performance, analyze key metrics, and identify areas for improvement, implementing data-driven optimizations to enhance product effectiveness.
• Stakeholder Management: Build and maintain strong relationships with key stakeholders, including claims operations, provider relations, finance, and compliance, ensuring alignment on product priorities and roadmap.
• Compliance and Regulatory: Stay abreast of relevant industry regulations and compliance requirements, ensuring that claims-related products adhere to all applicable standards.
• Mentoring and Leadership: Provide guidance and mentorship to junior product managers and contribute to the development of the product management team.

Minimum Qualifications:

• Bachelor's degree in a related field (e.g., Business Administration, Healthcare Management, Computer Science)
• 7+ years of experience in product management, with a focus on healthcare claims processing and payment
• In-depth knowledge of healthcare claims, including industry standards, regulations, and best practices
• Strong analytical and problem-solving skills, with the ability to interpret data and draw meaningful insights
• Excellent communication, interpersonal, and presentation skills
• Proven ability to work effectively in a cross-functional team environment

Preferred Qualifications:

• Master's degree in a related field
• Experience with Agile development methodologies
• Experience with claims adjudication systems (e.g., Facets, QNXT)Product Management certification (e.g., Pragmatic Marketing, Certified Product Manager)

Additional Details:

• 7+ years of experience in product management, with a focus on healthcare claims processing and payment ; Agile development methodologies ; Claims adjudication systems (e.g., Facets, QNXT) ; Product Management certification (e.g., Pragmatic Marketing, Certified Product Manager)