Description

Key Responsibilities

• Own and manage the product backlog for provider data and provider lifecycle capabilities.
• Define and prioritize epics, features, user stories, acceptance criteria, and product requirements.
• Partner with business and technology stakeholders to define and deliver provider data solutions.
• Drive capabilities across provider onboarding, credentialing, contracting, network management, provider directories, and provider data maintenance.
• Analyze complex, data-heavy payer business processes and translate them into clear product requirements and delivery plans.
• Collaborate with network operations, provider operations, credentialing, compliance, data, engineering, and other cross-functional teams.
• Identify opportunities to improve provider data quality, accuracy, governance, and operational efficiency.
• Evaluate downstream impacts of provider data changes on claims, payments, directories, networks, and other payer systems.
• Support modernization and transformation initiatives involving legacy provider data systems and platforms.
• Facilitate stakeholder discussions, refinement sessions, backlog reviews, sprint planning, and product prioritization activities.
• Ensure delivered capabilities align with business objectives, regulatory requirements, and provider data standards.

Required Qualifications

• Proven experience as a Product Owner or Product Manager in the healthcare payer/health insurance domain.
• Strong payer-side provider domain expertise gained within a health plan, health insurer, or organization directly serving payer operations.
• Hands-on experience with Provider Data Management (PDM) and/or Provider Lifecycle Management (PLM).
• Strong understanding of:
  • Provider onboarding
  • Provider credentialing
  • Delegated credentialing
  • Provider contracting
  • Provider hierarchies
  • Network management
  • Provider directories
  • Provider data governance
  • Claims and payment impacts

Demonstrated experience owning and prioritizing product backlogs.

Experience with Provider Data platforms and/or Master Data Management (MDM) solutions.

• Hands-on experience defining epics, features, user stories, acceptance criteria, and product requirements.
• Strong ability to translate complex and ambiguous business problems into actionable product requirements.
• Excellent cross-functional stakeholder management skills.
• Experience working closely with network, operations, credentialing, compliance, data, and engineering teams.

Preferred Qualifications

• Knowledge of provider directory accuracy and network adequacy requirements and regulations.
• Experience with provider contracts, agreements, and fee schedule structures.
• Experience with legacy provider data system modernization, migration, or transformation initiatives.
• Experience with provider data quality, governance, and data integration.
• CSPO or SAFe POPM certification.
• Experience working in Agile/Scrum product delivery environments

Key Skills

Education

Bachelor's degree