Product Owner

We are seeking a detail-oriented and execution-focused Product Owner to support the delivery of features and enhancements within our healthcare claims administration platform. This role is responsible for translating business and stakeholder needs into clear, actionable user stories and working closely with engineering teams to ensure timely, high-quality delivery. The ideal candidate brings healthcare domain knowledge, understands Agile processes, and is comfortable using AI-enabled tools to support requirements definition and backlog management.  

• Own and manage the product backlog, ensuring stories are well-defined, prioritized, and aligned with sprint goals 

• Write epics, user stories, and acceptance criteria that are clear, testable, and customer-centric 

• Conduct regular backlog grooming and sprint planning in collaboration with the Scrum team 

• Manage daily standups, sprint reviews, and retrospectives as an active team member 

• Ensure user stories meet the definition of ready and done before development and release 

• Collaborate with stakeholders, subject matter experts, and internal teams to gather and refine product requirements 

• Use AI tools (where applicable) to support the creation of epics, themes, and user stories 

• Conduct gap analysis and validation of requirements to ensure completeness and feasibility 

• Support refinement of use cases, workflows, and functional documentation 

• Bachelor’s degree in Business, Healthcare Administration, Computer Science, or a related field 

• 2+ years of product management experience; healthcare technology or claims administration preferred 

• 2+ years of experience working with AI tools for product development, requirements engineering, or business analysis preferred 

• Familiarity with Agile software development and Scrum methodology  

• Proficiency with Jira (or similar Agile tools) for backlog management 

• AI-Enabled Product Management
• Demonstrated experience incorporating AI tools into day-to-day product management activities
• Ability to establish and maintain reusable prompts, instructions, and workflows that improve requirements quality and team productivity
• Ability to validate, challenge, and refine AI-generated artifacts to ensure business, technical, regulatory, and operational accuracy

• Basic understanding of software development processes and technical constraints 

• Familiarity with collaboration tools (e.g., Confluence, Miro, Figma) 

• Strong written and verbal communication skills for conveying requirements and feedback 

• High attention to detail and organizational skills 

• Ability to manage competing priorities and meet deadlines in a fast-paced environment 

• Comfortable working with cross-functional teams and resolving blockers quickly 

• Experience working in healthcare technology, payer operations, care management, utilization management, claims administration, or related healthcare domain

• Certified Scrum Product Owner (CSPO) or similar Agile certification 

• Understanding of healthcare data standards (e.g., HL7, FHIR, X12 EDI) 

• Experience with Utilization Management, Prior Authorization, Care Management, Clinical Review, or related payer operations workflows
• Familiarity with medical necessity determination processes
• Familiarity with InterQual, MCG, or payer-specific clinical guidelines
• Understanding of healthcare regulatory requirements including CMS, NCQA, URAC, HIPAA, and state-specific UM regulations
• Experience collaborating with UM nurses, Medical Directors, physician reviewers, and clinical operations teams
• Knowledge of Commercial, Medicare Advantage, Medicaid, and Dual Eligible healthcare programs
• Familiarity with authorization intake, clinical review, peer review, and determination workflows
• Experience with workflow engines, rules engines, or clinical decision support systems

• Serve as the primary point of contact for development teams during sprint execution 

• Partner with UX/UI designers to ensure user stories are aligned with design principles and usability goals 

• Support QA teams by clarifying acceptance criteria and reviewing test cases as needed 

• Coordinate with other Product Owners to manage interdependencies between features 

• Participate in stakeholder meetings to capture feature requests, enhancement ideas, and feedback 

• Communicate updates to internal stakeholders on backlog priorities, delivery timelines, and sprint progress 

• Help ensure features delivered meet customer needs and stakeholder expectations 

• Apply working knowledge of healthcare claims workflows, billing terminology, and reimbursement processes 

• Support compliance with healthcare regulations (HIPAA, HITECH) in collaboration with internal teams 

• Assist in translating complex healthcare requirements into understandable product features