Principal Technical Product Manager – Autonomous Vehicle
Glydways
Technical Product Manager – Claims
Alignment Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $113,332 - $169,999 per year
Job Level
Mid-LevelSenior
Tech Stack
AWSAzureCloudETLSQLSSIS
About the role
- Drive the functional and technical roadmap for the Trizetto Claims platform, ensuring alignment with Medicare business priorities, CMS requirements, and enterprise technology goals.
- 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 in Facets.
- Oversee configuration of benefits, plan designs, pricing logic, provider contracts, and payment rules.
- Define requirements for batch jobs, APIs, and EDI transactions (837, 835, 277, 999) to support claims, member, and provider data flows.
- Translate CMS regulations and Medicare operational requirements into actionable business and system requirements.
- Partner with vendors to manage technical solutions and integrations, ensuring compliance with service-level agreements (SLAs).
- Monitor end-to-end claims payment workflows, ensuring accuracy and identifying opportunities for automation and efficiency.
- Serve as the functional-technical bridge between DTS, Claims Operations and Trizetto vendor teams.
Requirements
- 5+ years of Product Management or Business Analyst experience in healthcare payer systems, with at least 3 years focused on TriZetto Facets.
- Strong functional expertise in Medicare claims processing, provider contracting/setup, and Medicare member configuration and attributes.
- Proven hands-on expertise with: Microsoft SQL (querying, optimization, reconciliation, audits)
- ETL Tools such as Microsoft SSIS and Azure Data Factory
- Job Scheduling tools such as Redwood, Tidal and Control-M
- Cloud Platforms (Azure/AWS)
- Experience integrating vendor solutions
- Solid understanding of what drives Claims compliance in a Medicare environment.
- Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
TriZetto FacetsMedicare claims processingMicrosoft SQLETL ToolsMicrosoft SSISAzure Data FactoryJob Scheduling toolsRedwoodTidalControl-M
Soft skills
analytical skillsproblem-solving skillscommunication skills