ModMed

Product Owner – RCM Automation, AI

ModMed

full-time

Posted on:

Location Type: Remote

Location: Florida • United States

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Tech Stack

SQL

About the role

  • Define and deliver AI-powered RCM capabilities, including policy extraction agents, claim scrubbers, denial risk models, and intelligent automation workflows
  • Translate billing and payer policy complexity into structured logic suitable for AI models and rule engines
  • Collaborate with AI/ML engineers to define model inputs, outputs, evaluation criteria, and success metrics
  • Contribute to prompt engineering for LLM-based workflows, ensuring structured, testable, and reliable outputs aligned with billing accuracy standards
  • Participate in model evaluation, output validation, and iterative refinement to improve precision, recall, and operational trust
  • Use SQL and data analysis to identify trends in denials, scrub failures, payer policies, and operational inefficiencies
  • Support data orchestration efforts by defining required datasets, feature inputs, and transformation logic
  • Analyze automation performance using measurable KPIs (e.g., denial reduction, touch-time savings, automation rates)
  • Partner with engineering on experimentation frameworks and structured model testing
  • Convert high-level business problems into detailed epics and user stories with clear acceptance criteria
  • Create flow maps and workflow diagrams to communicate business logic, automation rules, and agent behavior
  • Break down AI and automation initiatives into incremental, deliverable features aligned with PI objectives
  • Ensure requirements address edge cases, data dependencies, and workflow impacts across enterprise and RCM users
  • Participate in SAFe Agile ceremonies, including backlog refinement, sprint planning, and stand-ups
  • Own JIRA epics and stories from concept through release
  • Triage and prioritize bugs, especially those related to AI output accuracy and automation reliability
  • Perform functional validation and assist in model output certification before release
  • Partner with Product Launch, Training, Support, Implementation, and RCM Operations to ensure successful feature rollout
  • Manage alpha and beta programs, gathering structured feedback to improve AI performance and usability
  • Act as a change agent promoting intelligent automation and measurable efficiency improvements across customer workflows

Requirements

  • 5+ years of experience in healthcare technology, with strong knowledge of medical billing and revenue cycle operations
  • Deep understanding of claims lifecycle, denials, payer policies, coding, modifiers, and appeals
  • Experience defining functional requirements in the form of user stories, process flows, and structured business logic
  • Basic working knowledge of SQL and ability to use data to support prioritization and validation
  • Foundational knowledge of AI/ML concepts, including: Large Language Models (LLMs), Agentic workflows and orchestration frameworks, Model evaluation metrics (precision, recall, accuracy), Prompt engineering for structured, reliable outputs
  • Ability to collaborate effectively with AI engineers on model behavior, testing, and refinement
  • Strong analytical thinking, problem-solving skills, and attention to detail
  • Experience working in Agile environments (SAFe preferred)
  • Familiarity with Jira, Confluence, and Google Suite
  • Experience working across distributed teams and time zones
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
SQLAIMLLarge Language Modelsprompt engineeringdata analysisfunctional requirementsmodel evaluation metricsautomation workflowsbusiness logic
Soft Skills
analytical thinkingproblem-solvingattention to detailcollaborationcommunicationchange agentprioritizationvalidationiterative refinementleadership