This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Technical Product Manager role for Clinical solutions merges product management, healthcare expertise, and technical knowledge to develop and manage software and technology solutions for Alignment Health. - Drive the functional and technical roadmap for Clinical Solutions, including Utilization, Care Management platforms, Clinical decision support systems, quality measures, and interoperability solutions leveraging Alignment’s proprietary AVA and Vendor platforms. - Ensure compliance with CMS, NCQA, HIPAA, and other regulatory requirements impacting clinical data and processes. - Anticipate regulatory and operational changes (e.g., CMS rule updates, encounter data submission requirements) and integrate them into the roadmap. - Lead the design, testing, and implementation of new features for Clinical solutions platforms. - Define and drive integration with Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and other clinical data platforms via APIs, HL7, FHIR, and batch interfaces. - Partner with data engineering teams to design solutions that support risk adjustment, HEDIS/Stars quality reporting, care gap closure, and population health analytics. - Define and prioritize features for provider-facing tools such as prior authorization, utilization management, case management, and clinical documentation improvements. - Collaborate with clinicians, business stakeholders, and technology teams to translate clinical workflows and requirements into scalable technical solutions. Qualifications - 5+ years of Product Management experience in healthcare technology, with a focus on clinical solutions. - Advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred. - Proven hands-on expertise with healthcare interoperability standards (FHIR, HL7, X12, CCD, CDA). - Microsoft SQL (querying, optimization, reconciliation, audits). - ETL Tools such as Microsoft SSIS and Azure Data Factory. - Cloud Platforms (Azure/AWS). - Experience integrating vendor solutions. - Strong knowledge of clinical workflows, care management, utilization management, and quality reporting. - Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes. Requirements - Bachelor’s degree in Healthcare Information Systems, Computer Science or related field; advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred. - MBA or advanced degree preferred. - Deep understanding of Provider Credentialing, Contracting and Reimbursement Strategies in a Medicare environment. - Experience with Medicare and Medicaid programs, including Stars, HEDIS, and risk adjustment. - Knowledge of clinical natural language processing (NLP) or AI-driven care management tools. - Proficiency in relevant technical tools, such as SQL, Azure Data Factory, Jira, and Confluence. - Experience in defining product strategies, managing product backlogs, and working within agile development methodologies. - Familiarity with payer platforms (Facets, QNXT, HealthRules) and provider EMRs (Epic, Athena, Cerner, Allscripts). - Vendor management and SLA performance oversight. Benefits - Pay Range: $113,332.00 - $169,999.00 - Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.