Product Manager Provider Platforms & AI-Driven Product Delivery

Role Summary

We are seeking a highly strategic and execution-oriented Product Manager with deep expertise in the healthcare provider domain to lead next-generation digital product initiatives across Provider Operations, Contracting, Network Management, Credentialing, Claims, and Member interactions.

This role is designed for a modern IT organization operating in an AI-first engineering environment. The ideal candidate combines strong provider business knowledge with exceptional product management capabilities, data fluency, process thinking, and advanced usage of AI tools for rapid ideation, prototyping, workflow visualization, and product design acceleration.

The Product Owner will partner closely with Engineering, Architecture, Operations, Data, and Business stakeholders to build scalable, event-driven, observable, and AI-enabled provider platforms.

Key Responsibilities

Provider Domain Leadership

Act as the primary product lead for provider-centric platforms and workflows.

Own product vision, roadmap, backlog, prioritization, and execution for provider-related initiatives.

Drive modernization of provider lifecycle capabilities including:- Provider onboarding, Credentialing & recredentialing, Provider data management

Contracting & fee schedules, Network creation and hierarchy management, TIN/NPI relationships, Affiliation and participation management, Directory accuracy and compliance, Claims integration and adjudication touchpoints, Member-provider interaction workflows

Product Strategy & Delivery

Translate complex business processes into scalable digital products and engineering outcomes.

Define product operating models aligned to agile delivery and value stream principles.

Create detailed user stories, acceptance criteria, process flows, and product specifications.

Prioritize work based on business value, operational impact, risk reduction, and customer experience.

Drive continuous improvement using product analytics, operational metrics, and user feedback.

AI-Driven Product Engineering

Leverage advanced AI tools for: Wireframing, UI/UX ideation, Workflow diagramming, Product documentation, Story generation, Rapid prototyping, Process simulation, Backlog acceleration, Use modern tools such as: Lucidchart / Miro, Figma AI, ChatGPT / Claude / Gemini, AI coding copilots, Workflow orchestration and visualization tools, Champion AI-native product delivery practices across teams.

Provider Data & Platform Expertise

Possess deep understanding of provider data models and relationships including:

NPI/TIN structures, Parent-child hierarchies, Contract entities, Locations and specialties, Network participation, Affiliation structures, Roster ingestion and validation, Data lineage and provenance

Work closely with engineering and architecture teams on:

APIs and schema contracts,Event-driven integrations, Cloud events, Data observability, Traceability and OTEL concepts

Cross-Functional Collaboration

Collaborate with: Engineering teams, Architects, Provider operations, Claims teams, Network management, Compliance, Analytics and reporting teams

Facilitate alignment between business strategy and technology implementation.

Lead stakeholder workshops, backlog grooming, sprint planning, and product demos.

Required Qualifications

• Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, or related field.
• 8+ years of experience in Product Ownership, Product Management, Business Architecture, or Provider Operations technology.
• Extensive experience in healthcare payer/provider ecosystems.
• Strong expertise in: Provider data management, Provider contracting, Network creation and optimization, Claims and member workflows, Credentialing operations.
• Strong understanding of agile methodologies and modern product operating models.
• Experience working with distributed engineering teams and enterprise platforms.

Preferred Qualifications

• Experience with healthcare platforms and ecosystems.
• Familiarity with: FHIR,HL7,Provider directory standards, Event-driven architecture, Graph-based relationship modeling , Data lineage frameworks, Exposure to observability frameworks and telemetry concepts.
• Experience with AI-assisted product development and AI-native delivery practices.

Key Skills

Domain Expertise

Provider Lifecycle Management, Provider Data & Network Management, Claims & Member Ecosystem, Credentialing & Contracting, Healthcare Operations

Product & Delivery

Agile / Scrum, Product Discovery, Roadmap Management, User Story Writing, Backlog Prioritization, Process Re-engineering

Technical & AI Skills

AI-powered product tooling

Workflow visualization

Wireframing & rapid prototyping

APIs & schema contracts

Event-driven architecture

Data lineage & observability

Analytical and systems thinking

Leadership Traits

• Systems thinker with strong operational acumen
• Highly collaborative and execution focused
• Ability to simplify complex provider workflows
• Strong communication and stakeholder management skills
• Bias toward automation, standardization, and measurable outcomes
• Comfortable operating in ambiguity and driving transformation initiatives

Success Metrics

• Reduction in provider onboarding and contracting cycle times
• Improved provider data quality and accuracy
• Faster product delivery velocity through AI-assisted workflows
• Increased automation and reduced operational touchpoints
• Improved member and provider experience
• Higher engineering productivity and backlog clarity