Lead Product Owner for Healthcare Payer Prior Authorization Process

BEFORE APPLYING FOR THE JOB. KINDLY READ THE COMPLETE JOB DESCRIPTION PROPERLY(EVEN THE TERMS OF EMPLOYMENT ALSO), NO 1099, C2C , H1TRANSFER

Title: Lead Product Owner

Location: 100% Remote (must work EST hours).

Terms of Employment:

• W2 contract 7-month (through end of year);

• 100% Remote (must work EST hours).

Overview:

Work with a leading Healthcare Payer organization as a Lead Product Owner / Business Integration Lead. You will drive a high-priority task force dedicated to correcting end-to-end fail points in the medical prior authorization process. This role is perfect for a seasoned industry veteran who understands both the clinical business needs and the technical IT integrations required to ensure medical authorizations flow successfully into the claims platform.

Key Responsibilities:

• Lead a cross-functional task force to identify and implement corrective actions for the end-to-end prior authorization process.

• Drive solutions across functional silos, including Claims, IT, and Clinical teams.

• Manage the process of extracting medical prior authorizations from Guided Care and successfully loading them into the Facets claims platform.

• Negotiate deliverables and solution options with claims teams to speed up the resolution of matching errors.

• Utilize 8-10 years of Product Owner experience to manage daily tasks, JIRA workflows, and leadership presentations.

Required Qualifications:

• 15 years of experience in the Healthcare Payer or Healthcare Delivery industry.

• 8-10 years of experience as a Product Owner.

• Strong working knowledge of the Facets claims platform, specifically regarding claims-to-auth matching logic.

• Experience with Guided Care (UI or extraction processes).

• Deep subject matter expertise in Prior Authorizations and the 278 transaction set.

• Ability to work a standard workday on Eastern Standard Time (EST).

Preferred Qualifications:

• Proficiency in JIRA and PowerPoint for task tracking and executive reporting.

• Previous experience in "Task Force" or rapid corrective action environments.