Product Manager — PriorAuth

Role overview

Accountabilities

• Own delivery around eligibility checks, form completion, medical necessity letters, case tracking, and other clinical workflows.
• Develop AI-enabled experiences that automate manual work, surface answers, accelerate decisions, and support agentic interactions.
• Write production-quality code and build prototypes, prompts, experiments, and other solutions with engineering.
• Define metrics, instrument analytics, query product data, and use adoption insights to guide investment decisions.
• Productionize AI through confidence thresholds, fallback mechanisms, evaluation criteria, reliability controls, and human-in-the-loop workflows.
• Shape integrations with electronic prior authorization, pharmacy, and electronic medical record systems, including FHIR-based exchange.
• Maintain security, compliance, access controls, auditability, trust, and HIPAA alignment in AI-assisted clinical workflows.
• Work with engineering, design, AI/data science, clinical, UX, business, and go-to-market stakeholders.

Requirements

• Bachelor’s degree in business, healthcare, computer science, or a related field, or equivalent professional experience.
• 3–5+ years of product management experience in healthcare technology, SaaS, or B2B platforms serving professional users.
• Hands-on coding ability and experience working alongside engineers with modern AI coding tools.
• Strong product-data capabilities, including metrics, SQL or equivalent querying, analytics, and data-driven prioritization.
• Experience with AI/ML, conversational AI, agentic automation, or clinical decision-support products.
• Practical understanding of prior authorization, pharmacy workflows, clinical case management, practice operations, or related processes.
• Familiarity with HIPAA, EHR systems, FHIR, HL7 v2, and CDA; TEFCA and QHIN knowledge is a plus.
• Experience with Epic SMART on FHIR and healthcare app marketplace certification requirements is advantageous.

Benefits

• Base salary of $110,000–$130,000 USD plus bonus, depending on experience and location.
• 100% remote work within the United States with occasional in-person team meetups.
• 401(k) matching, medical and other insurance coverage, HSA-related benefits, and pet insurance.
• Open paid time off, remote-work stipend, and annual education and professional development budget.
• Opportunity to reduce administrative burden across healthcare for professionals, patients, and families.