Vice President, Product, Medical Cost Containment & Authorization
Availity
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Lead the strategy, execution, and scale of Utilization Management (UM) product portfolio
- Own an end-to-end product suite that blends AI-driven decisioning, healthcare interoperability, and deep UM expertise
- Define and own the long-term product vision and roadmap for medical cost containment and authorization capabilities
- Align product strategy with enterprise affordability, quality, and growth goals
- Identify market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization
- Lead the end-to-end product lifecycle from concept through launch, optimization, and sunset
- Translate clinical, operational, and regulatory requirements into clear product requirements
- Partner with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions
- Ensure products support evidence-based medicine, medical policy, and evolving clinical guidelines
- Oversee products supporting prior authorization and other reviews
- Drive innovation in automation, rules engines, and AI-assisted review
- Collaborate with stakeholders to ensure integrity and regulatory adherence
- Support Sales and Client Management with product positioning, differentiation, and client engagement
Requirements
- Bachelor’s degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred
- 10+ years of experience in healthcare product management, medical management, or utilization management
- 5+ years in a senior product leadership role
- Deep expertise in prior authorization, utilization review, and medical cost containment strategies
- Strong understanding of managed care, payer operations, and healthcare regulations
- Experience working with clinical teams and medical policy development
- Background in digital health, automation, or AI-enabled clinical workflows
- Proven success launching complex, regulated healthcare products at scale
- Strategic product leadership and executive-level communication
- Ability to translate clinical and regulatory complexity into usable products
- Strong analytical and financial acumen
- Collaborative leadership across clinical, technical, and business teams
- Comfort operating in highly regulated, fast-changing environments
Benefits
- Competitive salary
- Bonus structure
- Generous HSA company contribution
- Healthcare, vision, dental benefits
- 401k match program
- Unlimited PTO for salaried associates + 9 paid holidays
- Up to $250/year reimbursement for gym memberships and wellness programs
- Education reimbursement
- Paid parental leave for both birth and adoptive parents
- Community engagement opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
utilization managementproduct managementmedical cost containmentprior authorizationhealthcare interoperabilityAI-driven decisioningautomationrules enginesclinical workflowsmedical policy development
Soft Skills
strategic product leadershipexecutive-level communicationanalytical acumenfinancial acumencollaborative leadershipstakeholder engagementinnovationproblem-solvingadaptabilityregulatory adherence
Certifications
Bachelor’s degreeMBAMHAMPHRNMD