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Product Manager, Prior Authorizations
Location
United States
Posted
154 days ago
Salary
0
Seniority
Senior
Job Description
Product Manager, Prior Authorizations
Availity
• Define and communicate a clear product roadmap aligned with CMS requirements, industry trends, and organizational goals • Gather and document business requirements through stakeholder interviews and workflow analysis • Translate requirements into user stories, acceptance criteria, and API specifications for engineering teams • Validate interoperability standards (X12 278, FHIR CRD/DTR/PAS) for transactions between EHRs, Availity, and payer/vendor systems • Collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases • Serve as the subject matter expert on prior authorization workflows and FHIR standards; provide guidance internally and externally • Monitor CMS mandates, industry trends, and client feedback to inform product decisions and prioritize features • Lead pilots, define KPIs/OKRs, and drive successful go-to-market strategies • Define product performance metrics and partner with data teams to deliver actionable insights for ROI and gainshare • Align executives, clients, and internal teams on product vision, progress, and outcomes
Job Requirements
- Minimum of 5 years’ experience in Product Management preferably with client facing experience within healthcare technology
- Deep expertise in prior authorizations workflows
- Strong technical background with an understanding of the CMS 0057-F requirements for prior authorization and the X12 278 EDI and FHIR prior authorization (CRD, DTR, and PAS) transactions
- Knowledge of EHR systems and utilization management platforms and vendors
- Technical acumen, ability to gather and describe market requirements and get feedback from technical staff and customers
- Business acumen: ability to contribute to a business case, evaluate feasibility & scalability, and driving ROI
- Familiarity with regulatory requirements and compliance standards
- Proven ability to lead cross-functional initiatives and influence stakeholders
Benefits
- Competitive salary
- Bonus structure
- Generous HSA company contribution
- Healthcare benefits
- Vision benefits
- Dental benefits
- 401k match program on day one
- Unlimited PTO for salaried associates + 9 paid holidays
- 19 days of PTO for hourly associates
- Gym membership reimbursement up to $250/year
- Education reimbursement
- Paid Parental Leave for both moms and dads
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