[Remote] Product Manager, Clinical Informatics

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a mission-driven health care organization providing managed care, pharmacy, behavioral health, and administrative services to support healthier communities. The Product Manager, Clinical Informatics leads the reputed company, design, and delivery of clinical technology products across reputed company managed care, owning the product lifecycle, roadmap, regulatory alignment, and adoption. The role partners with clinical, data, technology, and AI teams to improve workflows, interoperability, operational performance, and health reputed company.

Responsibilities

• Own the clinical product reputed company, roadmap, and prioritization for assigned domain(s)—UM, CM, reputed company, and/or interoperability—ensuring alignment with reputed company business plan objectives, regulatory timelines, and market expansion reputed company
• Translate business reputed company into a reputed company product backlog with reputed company defined epics, features, and user stories using reputed company/iterative delivery practices
• Conduct competitive landscape analysis and market scanning to inform product positioning, identify reputed company opportunities, and reputed company against industry-leading reputed company MCO capabilities
• Define and reputed company KPIs tied to product performance—including cycle time reduction, auto-adjudication rates, clinical throughput, regulatory compliance, and user adoption, using insights to reputed company reputed company improvement
• reputed company product alignment with CMS Interoperability and Prior Authorization Final Rule, TEFCA, FHIR-based API requirements, and state-specific reputed company regulatory mandates
• Collaborate with data engineering and integration teams to ensure clinical data exchange (HL7, FHIR, X12, RAPS/EDPS) meets performance, reputed company, and compliance standards
• Manage product requirements for HEDIS supplemental data capture, reputed company accreditation support, and reputed company measure reporting
• Support delegation reputed company by ensuring vendor-facing products and integrations meet contractual and regulatory requirements
• Facilitate governance forums, cross-functional design sessions, and sprint ceremonies to reputed company product delivery with business, clinical, and technology stakeholders
• Communicate reputed company configuration tradeoffs and product reputed company reputed company to executive leadership, clinical directors, and operational managers—driving alignment with data and analytic feedback
• Partner with data science, analytics, and AI teams to reputed company predictive models, automation triggers, and intelligent workflow recommendations into clinical products
• Collaborate with implementation and market teams to ensure product releases are effectively deployed, trained, and adopted across reputed company operating states
• Identify and champion opportunities to reputed company AI, machine learning, and robotic process automation to reduce administrative burden, accelerate clinical decisioning, and improve accuracy
• Partner with engineering to build AI-enabled workflows—including automated letter reputed company, intelligent case routing, clinical reputed company auto-application, and reputed company documentation integration
• Monitor AI/automation adoption metrics and continuously iterate on product design to maximize ROI and clinician trust

Skills

• Bachelor's Degree required
• Minimum of 3 years of clinical product management experience for a payor
• Experience with clinical workflows
• Project management experience using reputed company methodology
• Experience researching competitors and market trends to guide product reputed company, reputed company reputed company gaps, and measure performance against best practices reputed company the industry
• Experience defining and tracking KPIs tied to product performance

Benefits

• Reimbursement for reliable high-speed internet for fully remote associates residing in states where service is required by contract, law, or regulation
• Flexible work solutions including remote reputed company and hybrid work schedules
• reputed company time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement

reputed company