Job Overview
Location
Remote - United States
Job Type
Full-time
Category
Product Management
Date Posted
April 18, 2026
Full Job Description
đź“‹ Description
- • Lead the strategy, execution, and scale of Availity’s Utilization Management product portfolio, focusing on medical cost containment and authorization solutions that blend AI-driven decisioning, healthcare interoperability, and deep UM expertise to modernize and disrupt utilization management across the healthcare ecosystem.
- • Define and own the long-term product vision and roadmap for medical cost containment and authorization capabilities, aligning product strategy with enterprise affordability, quality, and growth goals while identifying market trends, regulatory changes, and competitive opportunities.
- • Lead the end-to-end product lifecycle from concept through launch, optimization, and sunset, translating clinical, operational, and regulatory requirements into clear product requirements and prioritization, and partnering with engineering and data teams to deliver scalable, configurable solutions.
- • Oversee products supporting prior authorization, concurrent review, retrospective review, and specialty management, driving innovation in automation, rules engines, AI-assisted review, and straight-through processing while balancing cost containment objectives with access to care, provider experience, and member satisfaction.
- • Collaborate with stakeholders across products to ensure integrity and regulatory adherence, partner with Leadership & Finance to quantify savings impact and ROI, and support Sales and Client Management with product positioning, differentiation, and client engagement.
- • Ensure products comply with federal and state regulations (e.g., CMS, NCQA, URAC, state DOI requirements), support audit readiness and accreditation standards related to utilization management, and establish KPIs and governance models to monitor product performance, outcomes, and quality.
- • Build, mentor, and lead high-performing product management teams, fostering a culture of accountability, innovation, and continuous improvement.
🎯 Requirements
- • Bachelor’s degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred.
- • 10+ years of experience in healthcare product management, medical management, or utilization management.
- • 5+ years in a senior product leadership role.
- • Deep expertise in prior authorization, utilization review, and medical cost containment strategies.
- • Strong understanding of managed care, payer operations, and healthcare regulations.
- • Experience working with clinical teams and medical policy development.
🏖️ Benefits
- • Competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits, and a 401k match program available from day one.
- • Unlimited PTO for salaried associates plus 9 paid holidays; hourly associates start at 19 days of PTO and accrue more with the same holiday benefits.
- • Education reimbursement and paid parental leave for both moms and dads, including birth and adoptive parents.
- • Wellness reimbursement of up to $250/year for gym memberships, racing events, weight management programs, and similar activities.
- • Casual dress code (jeans allowed) and participation in a certified “Great Place to Work” culture with culture teams, Young Professionals Group, and pop-up lunches.
- • Opportunity to engage in community volunteer initiatives through Availity’s partnerships with local and national organizations.
Skills & Technologies
About Availity, LLC
Availity operates a nationwide health information network that connects health plans, providers, and technology partners to exchange administrative, clinical, and financial data in real time. The company offers APIs, web portals, and revenue cycle management tools that automate eligibility verification, prior authorization, claims processing, and patient financial engagement. Serving hospitals, physician practices, and payers across the United States, Availity processes billions of transactions annually, reducing administrative costs and improving care coordination.
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