Job Description

Title: Clinical Product Owner

Seeking a Clinical Product Owner / Business Integration Lead
Focused on Healthcare Prior Authorization processes
Strong collaboration with Clinical, Business, Claims, and IT teams
Lead initiatives to improve and redesign Prior Authorization workflows
Opportunity to work on enterprise healthcare transformation projects

Key Responsibilities:
Analyze current Prior Authorization workflows end to end
Identify process gaps, pain points, and system failures
Drive resolutions across Clinical, Claims, and IT teams
Lead discussions with business and executive stakeholders
Support integration between GuidingCare and FACETS
Ensure successful extraction and loading of authorizations
Manage day-to-day clinical operational initiatives
Execute existing transformation and optimization plans

Required Skills:
15+ years of healthcare industry experience
8+ years as a Clinical Product Owner / Product Manager
Deep expertise in Clinical Prior Authorizations (End-to-End)
Strong experience with FACETS and Claims Processing
Hands-on knowledge of 278 Transactions
Basic working knowledge of GuidingCare
Excellent stakeholder management and communication skills
Strong analytical and process improvement capabilities

Ideal Candidate:
Strong business and clinical product background
Not seeking a purely IT Product Manager profile
Ability to work independently with minimal handholding
Expert understanding of Prior Authorization workflows
Experience driving enterprise healthcare operational improvements

Preferred Experience:
Utilization Management (UM) Programs
Healthcare payer operations
Cross-functional healthcare integration projects
Executive-level reporting and communication