Product Manager, Authorizations
Availity
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- 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)
- collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases
- serve as subject matter expert on prior authorization workflows and FHIR standards
- 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
- align executives, clients, and internal teams on product vision, progress, and outcomes
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 understanding of CMS 0057-F requirements for prior authorization and X12 278 EDI and FHIR transactions
- knowledge of EHR systems and utilization management platforms
- technical acumen, ability to gather and describe market requirements and get feedback from technical staff and customers
- business acumen: ability to contribute to 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
- product background highly preferred
- proficiency in analyzing data and finding actionable insights
- experience with AI-driven utilization management solutions and automation technologies
- knowledge of the full revenue cycle is a plus
Benefits
- competitive salary
- bonus structure
- generous HSA company contribution
- healthcare
- vision
- dental benefits
- 401k match program
- unlimited PTO for salaried associates + 9 paid holidays
- 19 days of PTO for hourly associates
- reimbursement up to $250/year for gym memberships and wellness programs
- education reimbursement
- Paid Parental Leave for both moms and dads
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
product managementprior authorization workflowsCMS 0057-F requirementsX12 278 EDIFHIR transactionsEHR systemsutilization management platformsdata analysisAI-driven solutionsautomation technologies
Soft Skills
stakeholder managementcross-functional leadershipcommunicationbusiness acumeninfluencecollaborationproblem-solvingstrategic thinkingfeedback gatheringKPI/OKR definition