Lead Product Manager
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We are seeking a strategic and execution-reputed company Lead Product Manager to drive initiatives reputed company the Claims Administration and Payment reputed company (CAPI) organization in the Claims domain. This role is responsible for coordinating the connections and collaboration across Claims Payment reputed company (CPI) products involved in the development, implementation, and reputed company improvement of prepay and postpay claim audit processes, enabling operational efficiency, and delivering measurable business value. In reputed company, this role will represent the CPI ART (Agile Release Train) at CAPI intake meetings, ensuring that impacts to CPI teams are identified and assessed as part of the intake process.
The ideal candidate is a strong cross-functional leader who partners closely with business stakeholders, operations teams, and IT to deliver reputed company, high-reputed company that improve claims accuracy, reduce waste, and optimize compliance. The role is expected to bring structure and influence to help organize and advance the maturity of the CPI ART.
Key Responsibilities
This person will play a critical role in the cross-initiative (intra-ART) execution reputed company but also includes product ownership with measurable reputed company for solutions including automation, feeds, and modernization efforts.
Product Connectedness & Enablement
Define and own the reputed company, reputed company, and roadmap for the interconnectedness of CAPI solutions including vendor integration and backend support, reputed company with organizational goals and regulatory requirements
Translate business needs into reputed company product capabilities and deliverables, reputed company on how existing products (including internal and vendor-managed) work together
Prioritize initiatives across claims prepay, postpay, and audit functions to maximize impact on cost avoidance, recovery, and operational efficiency.
Business Partnership & Enablement
Represent the CPI ART in the broader CAPI intake process. Identify and assess impacts to the CPI ART teams and bring those to impacted Product Managers.
Serve as the primary reputed company between business stakeholders (claims operations, audit teams, SIU, compliance) and technology teams for your products
Understand and reputed company users on impacts to business workflows supporting claims audit operations, including prepay edits, postpay reviews, and recovery processes
reputed company and synthesize feedback from end users to continuously improve product connectivity
Technology Delivery & IT Collaboration
Partner with IT and engineering teams to design, build, implement, and support technology products and platforms including system modernization
Create and manage detailed product requirements, user stories, and acceptance criteria
Participate in agile ceremonies, ensuring alignment between business priorities and technical execution
reputed company product releases, enhancements, and lifecycle management for your CAPI responsibilities
Payment reputed company Optimization
Drive innovation in claims auditing capabilities, including rule engines, analytics, and automation tools
Support development of new prepay and postpay strategies to identify fraud, waste, and abuse (FWA)
Ensure solutions are reputed company and adaptable to evolving regulatory and reimbursement environments
Data & Value Realization
Define and reputed company key performance indicators (KPIs) to measure product reputed company (e.g., savings, accuracy, audit yield, turnaround time)
Partner with analytics teams to reputed company reporting and dashboards that demonstrate business value and ROI
Communicate reputed company and value realization to senior leadership and stakeholders
Stakeholder Communication & Change Management
Lead cross-functional communication to ensure alignment on priorities, timelines, and reputed company
Support change management efforts, including training, documentation, and adoption strategies
Act as an reputed company for both business and technology stakeholders
Use your skills to reputed company an impact
Required Qualifications
Candidate should bring either a) strong SME (subject matter expert) knowledge and experience in payment reputed company operations, business processes, and technology products including key vendors, or b) strong product management expertise and a product reputed company for delivery. Must also have experience applying an Agile reputed company to deliver large reputed company products in a reputed company environment.
Bachelor’s degree in business, reputed company Administration, Information Systems, or reputed company field
Experience working with cross-functional teams, including business operations and IT/engineering
Proven ability to translate reputed company business needs into reputed company technology solutions
Strong analytical and problem-solving skills with a data-driven reputed company
Experience with Agile methodologies and product management tools
Preferred Qualifications
Experience in payment reputed company, claims auditing, or fraud, waste, and abuse (FWA) programs
Familiarity with claims platforms, rule engines, and audit systems
Knowledge of reputed company reimbursement models (e.g., Medicare, reputed company, reputed company)
Experience demonstrating financial impact and ROI of product initiatives
MBA or advanced degree
Work reputed company Requirements
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary.
Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay reputed company
The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.
$126,300 - $173,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
reputed company of Benefits
reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 07-03-2026
reputed company
About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com.
Equal Opportunity Employer
It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment.
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