Job Information
Brighton Health Plan Solutions, LLC Product Manager, Clinical Systems Payer (Insurance) in New York, New York
About The Role
Reporting to Product and Portfolio Delivery Organization, The Clinical Product Manager will support the clinical and technology teams of Brighton. This is not a Clinician Position, but rather Healthcare Payer position. The ideal candidate will have a strong healthcare product background and understand the healthcare clinical system lifecycle around case management, Utilization management and population health management. This individual is expected to recognize business challenges and the inversion to scalable product solutions and translation into engineering requirements. This position requires comfort within ambiguous environments and supporting cross functional teams.
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
Primary Responsibilities
Collaborate with Clinical Programs leaders and the technology team for streamlined implementation and management of the clinical platform.
Act as Product Owner for the end-to-end customization and implementation of the vendor-partner clinical platform and technologies to support the scope of clinical teams including but not limited to: utilization management, care management, and appeals.
Collaborate with clinical operations to document as-is and to-be workflow processes including primary and alternate flows, business rules, conditions, and process artifacts.
Acts as conduit between Clinical Operations and Engineering to ensure mutual understand regarding desired functionality, dependencies, and negotiation delivery timeline.
Create, maintain, and prioritize backlog items based on the business and functional requirements. Maintain the Product Roadmap
Determine requirement acceptance criteria and plan and oversee user acceptance testing on all releases.
Collaborate with Training to support the development of operational and technology training materials for new implementation as well as enhancement functionalities.
Collaborate with clinical operations to document product performance metrics and reporting and identify opportunities for process and technical optimization.
Proactively assess, communicate, and mitigate project risks and maintain up-to-date tracking of key milestones and delivery dates.
Execute research to discover the needs and wants of our customers.
Essential Qualifications
BA/BS degree in a business or technical field, or equivalent practical experience; master’s degree preferred.
Strong project management skills and excellent organizational and communication skills.
Strong product management skills.
Process fluency in domains of Utilization Management and Care Management.
5+ years in healthcare technology capacity preferably working directly developing or customizing Utilization Management and Care Management systems.
Demonstrated experience customizing and optimizing third-party SAS systems.
Experience coordinating multiple cross-functional teams and initiatives, ideally through an Agile framework.
Demonstrated leadership in product definition and implementation.
Ability to interface across various levels within the organization.
Preferred Qualifications
Experience with ZeOmega’s Jiva platform is desirable.
Excellent self-starter/self-management comfortable with handling change and ambiguity.
Strong understanding of typical software development processes; working knowledge of agile software development methodology.
Demonstrate superb decision-making skills by engaging experts while determining alternatives and quickly synthesizing information, deriving insights, and devising solutions.
Excellent team player with the ability to consistently demonstrate the highest levels of professionalism, integrity, mutual respect, and accountability to others; ability to maintain strong relationships across key stakeholders and constituents.
Start-up mentality and comfortable innovating at a fast pace
Understanding of the conceptual, strategic, and technical aspects of an issue. Capable of grasping these concepts quickly and translating the impacts to the client.
Annual Salary Range: $120,000 - $140,000
The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity.
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