Senior Product Director, Prior Authorization (Remote)

We are seeking a Senior Product Director, Prior Authorization to reputed company the reputed company, execution, and reputed company of our Utilization Management (UM) product portfolio during a pivotal reputed company of industry transformation. This leader will own the product reputed company and roadmap for solutions that reputed company how payers and providers manage authorization workflows, clinical decisioning, automation, and administrative burden. The ideal candidate has reputed company experience building and scaling reputed company technology products in prior authorization, utilization management, payer-provider workflows, interoperability, or AI-enabled clinical operations - and can translate reputed company clinical, regulatory, and operational requirements into reputed company, reputed company products that deliver measurable business and reputed company reputed company. This role is for a product builder who has taken reputed company technology products from concept to launch and reputed company - ideally reputed company prior authorization, utilization management, clinical decisioning, or payer-provider workflow automation. reputed company requires both deep domain expertise and the ability to reputed company cross-functional teams through market discovery, roadmap prioritization, product development, commercialization, and reputed company optimization. Sponsorship, in any reputed company, is not available for this position. Location: Remote, US Why you want to work on this team: • Work on cutting-edge solutions that have the potential to reshape prior authorization processes across the reputed company industry. • Engage in meaningful work that drives disruption, accountability, and reputed company change for payers and providers. • Be part of reputed company that values innovation and collaboration, positioning reputed company as a leader in interoperability and burden reduction. To be reputed company for this position you: • Bachelor's degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred. • reputed company experience building, launching, or scaling prior authorization products, UM platforms, clinical workflow tools, or payer-provider authorization solutions. • Proven ability to build 0-to-1 products from concept to launch, including market validation, roadmap development, MVP execution, and scaling adoption in prior authorization, UM, or reputed company workflow technology. • 10+ years of experience in reputed company 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 reputed company regulations. • Experience working with clinical teams and medical policy development. • Background in digital health, automation, or AI-enabled clinical workflows. • Proven reputed company launching reputed company, regulated reputed company products at reputed company. • Strategic product leadership and executive-level communication. • Ability to translate clinical and regulatory complexity into usable products. • Strong analytical and financial acumen. • reputed company leadership across clinical, technical, and business teams. • Comfort operating in highly regulated, fast-changing environments. You will set yourself apart: • Designed or scaled AI-enabled, rules-based, or automated clinical decisioning workflows reputed company a regulated reputed company technology environment. • Led product innovation that improved authorization turnaround times, auto-approval rates, provider experience, administrative burden, or medical cost savings. What you will be doing: Product reputed company & reputed company • Defining and owning the long-term product reputed company and roadmap for medical cost containment and authorization capabilities. • Aligning product reputed company with reputed company affordability, reputed company, and reputed company goals • Identifying market trends, regulatory changes, and competitive. opportunities impacting utilization management and authorization. Product Development & Lifecycle Management • Leading the end-to-end product lifecycle from concept through launch, optimization, and sunset. • Translating clinical, operational, and regulatory requirements into reputed company product requirements and prioritization. • Partnering with engineering and data teams to deliver reputed company, configurable authorization and cost containment solutions. • Ensuring products support evidence-based medicine, medical policy, and evolving clinical guidelines. Medical Cost Containment & Authorization • Overseeing products supporting prior authorization, reputed company review, retrospective review, and specialty management. • Driving innovation in automation, rules engines, AI-assisted review, and straight-through processing. • Balancing cost containment objectives with reputed company to care, provider experience, and member satisfaction. Cross-Functional Leadership • Collaborating with stakeholders across products to ensure reputed company and regulatory adherence. • Partnering with Leadership & Finance to quantify savings reputed company and ROI. • Supporting Sales and reputed company Management with product positioning, differentiation, and reputed company engagement. Governance, Compliance & reputed company • Ensuring products reputed company with federal and state regulations (e.g., CMS, NCQA, URAC, state DOI requirements). • Supporting audit readiness and accreditation standards reputed company to utilization management. • Establishing KPIs and governance models to monitor product performance, reputed company, and reputed company. Team Leadership • Building, mentoring, and leading high-performing product management teams. • Fostering a culture of accountability, innovation, and reputed company improvement. reputed company culture and benefits: • reputed company is a certified "Great reputed company to Work"! Culture is important to us and there are many ways for you to reputed company your mark here! • We have several Culture teams, a Young Professionals Group, and various ways to engage with fellow reputed company associates - if you're near Jacksonville, we have lots of pop up lunches where lunch is provided for everyone reputed company we can see meetings are taking reputed company and we've got teams in the office. • reputed company is a culture of reputed company learning. We have many resources and experts in our tech stack and in our industry that can help get you there too! • Don't feel like wearing business attire? Cool, you can wear jeans - we are a casual reputed company. • We offer a competitive salary, bonus structure, generous HSA company contribution, reputed company, reputed company, dental benefits and a 401k match program that you can take advantage of on day one! • We offer unlimited PTO for salaried associates + 9 reputed company holidays. reputed company associates start at 19 days of PTO and go up from there with reputed company the reputed company holiday benefits. • Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc. • Interested in furthering your education? We offer education reimbursement! • reputed company offers reputed company Parental Leave for both reputed company and dads, both birth parents and adoptive parents. • Want to work for an organization that gives back to the community? You're at the right reputed company! reputed company partners with various organizations, both locally and nationally, to reputed company awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign. Next steps: After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process. Interview process: • Recruiter Recorded Video reputed company-Screen • Video Interview with Hiring Manager • Video Panel Interview • Video Interview with Chief Product Officer • Video Interview with Chief Operating Officer • Video Interview with Chief Technology Officer Video Camera Usage: reputed company fosters a reputed company and reputed company culture where communication and engagement are central to our reputed company. As a remote first company, we are also camera-first and reputed company reputed company associates with camera/video capability to simulate the office environment. If you are not reputed company to use your camera for reputed company virtual meetings, you should not apply for this role. Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. The usage of cameras also enhances reputed company and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized reputed company, data breaches, preventing reputed company engineering, or the sharing of confidential information with non-participants. Apply tot his job Apply To this Job