Product Owner

• Own and prioritize product backlogs for Provider Data Management (PDM), Provider Lifecycle Management (PLM), and Healthcare Capitation.
• Define and maintain Epics, User Stories, Acceptance Criteria, and Product Requirements.
• Manage provider lifecycle processes including:
• Provider onboarding
• Provider enrollment
• Credentialing
• Contracting
• Provider maintenance
• Provider termination
• Drive Provider Data Management, data quality, and provider network initiatives.
• Support provider assignments, capitation payments, reconciliation, and disbursement processes.
• Collaborate with Provider Network, Finance, Actuarial, Operations, Business, and Engineering teams.
• Lead Sprint Planning, Backlog Refinement, Sprint Reviews, UAT, and product demonstrations.
• Manage defects, production validation, releases, risks, dependencies, and production sign-off.
• Ensure product processes align with CMS, Medicare/Medicaid, HIPAA, and provider contract requirements.
• Define and track KPIs related to:
• Provider data quality
• Provider lifecycle processing
• Payment accuracy
• Capitation reconciliation
• Provider network operations

We are seeking an experienced Product Owner with strong expertise in Provider Data Management (PDM), Provider Lifecycle Management (PLM), and Healthcare Capitation to lead Agile product initiatives within a Healthcare Payer / Health Plan environment.

The ideal candidate will have hands-on experience managing provider-focused products and processes, including provider onboarding, enrollment, credentialing, contracting, maintenance, termination, provider data quality, network management, capitation payments, reconciliation, and disbursement., * 5+ years of experience as a Product Owner, Product Manager, or Business Analyst in Agile environments.

• Strong experience in Healthcare Payer / Health Plan / Managed Care environments.
• Strong hands-on experience with Provider Data Management (PDM).
• Strong experience with Provider Lifecycle Management (PLM).
• Strong experience with Healthcare Capitation.
• Experience with Provider Network Management.
• Experience with Provider Enrollment and Credentialing.
• Experience with Provider Contracting.
• Strong understanding of:
• Product Backlog Management
• Epics
• User Stories
• Acceptance Criteria
• Requirements Management
• UAT
• Defect Management
• Production Validation / Sign-off
• Experience with Agile / Scrum / SAFe methodologies.
• Experience with Jira and Confluence.
• SQL experience is preferred.

Preferred Healthcare Domain Experience

Candidates with experience in the following areas are highly preferred:

• Healthcare Payer
• Health Plans
• Managed Care
• Provider Networks
• Provider Data
• Provider Lifecycle
• Provider Enrollment
• Credentialing
• Provider Contracting
• Capitation
• Provider Payment
• Capitation Reconciliation