Job Description

Company Introduction

Availity is one of the leading health information networks in the United States, processing more than 4 billion transactions annually and connecting more than two million healthcare providers and over two thousand technology partners to health plans nationwide. Our teams of technology, business, and customer service professionals in Bangalore, India, are working together to transform healthcare delivery in the United States through innovation and collaboration. Our technologists help develop cutting-edge revenue cycle solutions that help hospitals, health systems, and physicians maximize payments and optimize their workflows.

• We are looking for a strong Product Manager to own and drive key product initiatives within the Payment Accuracy domain. This role will focus on building scalable, reliable, data-driven product capabilities that help reduce claim errors, prevent avoidable denials, improve payment accuracy, reduce operational rework, and deliver measurable value for payers and providers.
• The ideal candidate is not just a backlog manager or delivery coordinator. We are looking for someone who can understand complex healthcare workflows, identify the real customer and business problems, define clear product outcomes, collaborate deeply with engineering and cross-functional teams, and drive measurable impact.
• This role requires strong product judgement, healthcare domain curiosity, technical fluency, data orientation, stakeholder leadership, and the ability to operate in ambiguity. The Product Manager will be expected to own outcomes from discovery through delivery, launch, adoption, and continuous improvement.

Roles & Responsibilities

Key Responsibilities:

• Product Strategy & Outcome Ownership
• Own a defined product area within Payment Accuracy from discovery to delivery and post-launch optimisation.
• Translate customer problems, business goals, and operational needs into clear product outcomes and prioritised initiatives.
• Build and maintain an outcome-oriented roadmap that balances customer value, business impact, technical feasibility, operational readiness, and speed to market.
• Make thoughtful trade-off decisions across competing priorities such as customer needs, revenue impact, implementation complexity, operational risk, and engineering capacity.
• Define success metrics upfront and measure whether the product delivered the intended customer and business outcomes.
• Drive clarity on what problem is being solved, why it matters, what success looks like, and what should be done next.

Customer, Domain & Market Understanding

• Develop strong understanding of U.S. healthcare payer-provider workflows, claims lifecycle, payment integrity, payment accuracy, denials, edits, rework, resubmissions, and operational abrasion.
• Understand how payment accuracy capabilities help prevent avoidable claim issues earlier in the workflow rather than only addressing them downstream.
• Gather insights from customers, implementation teams, support teams, operations, sales, product marketing, analytics, and engineering.
• Convert customer pain points and operational friction into clear problem statements, hypotheses, and product opportunities.
• Identify where product improvements can reduce manual effort, improve accuracy, increase adoption, reduce turnaround time, and create measurable customer value.
• Stay informed on market trends, competitive approaches, and evolving expectations in payment integrity, claim accuracy, automation, and healthcare workflow optimisation

Product Discovery & Requirements Definition

• Lead structured product discovery before solutioning.
• Validate problems using qualitative and quantitative inputs.
• Define clear product requirements, user stories, acceptance criteria, workflow documentation, and decision records.
• Ensure requirements are complete, testable, and traceable, including assumptions, dependencies, open questions, edge cases, risks, and validation expectations.
• Work with engineering, QA, design, data, and operations teams to identify feasibility concerns, implementation risks, downstream impacts, and support needs early.
• Ensure stories and epics are ready for development with clear scope, business context, success criteria, and validation approach.
• Avoid jumping directly to features; focus first on the root problem, desired outcome, and evidence needed to support the decision

Payment Accuracy Workflow & Product Execution:

• Own product capabilities related to payment accuracy workflows such as claim validation, edit/rule logic, requirements intake, configuration workflows, operational tooling, analytics enablement, and customer-value measurement.
• Improve the clarity, consistency, and scalability of how payment accuracy capabilities are defined, built, launched, supported, and measured.
• Help reduce dependency on manual processes, tribal knowledge, duplicate logic, and one-off customisation.
• Drive product decisions that improve speed to value, repeatability, reliability, and customer confidence.
• Partner with engineering and QA to ensure edge cases, exceptions, failure scenarios, and validation needs are well understood before release.
• Support continuous improvement of workflows after launch based on usage data, stakeholder feedback, customer outcomes, and operational learnings.

AI, Automation & Process Optimisation:

• Identify opportunities to use AI, automation, and workflow intelligence to improve product discovery, requirements analysis, operational efficiency, and delivery throughput.
• Use AI tools responsibly as accelerators for synthesis, analysis, documentation, backlog refinement, and decision support.
• Ensure AI-assisted workflows remain explainable, validated, auditable, and supported by clear human accountability.
• Partner with engineering to evaluate where automation can reduce manual effort, improve quality, reduce rework, and increase speed to value.
• Apply strong judgement over AI-generated outputs; do not treat automation as a substitute for product thinking, domain understanding, or validation.
• Look for opportunities to simplify workflows, reduce handoffs, improve decision quality, and improve operational scalability.

Data, Metrics & ROI:

• Define and track product success metrics such as adoption, usage, turnaround time, error reduction, denial reduction, rework reduction, repair rate, implementation effort, operational efficiency, customer satisfaction, and ROI.
• Use data to prioritise product opportunities, validate hypotheses, and evaluate post-launch success.
• Partner with analytics teams to convert product and operational data into actionable insights.
• Help build clear value stories that connect product capabilities to customer outcomes and business impact.
• Support repeatable ROI models that can be used for customer conversations, internal prioritisation, sales enablement, renewals, and expansion.
• Ensure product decisions are grounded in evidence, not assumptions alone.

Technical Fluency & Platform Thinking:

• Work effectively with engineering teams on APIs, data flows, system behaviour, rule logic, workflow design, dependencies, integration points, scalability, reliability, and technical trade-offs.
• Participate meaningfully in technical discussions without needing to be the engineer.
• Understand enough about system behaviour to ask the right questions, identify risks, and make informed product decisions.
• Support products that are scalable, supportable, secure, reliable, and usable.
• Ensure product requirements include operational readiness considerations such as monitoring, support process, failure handling, documentation, versioning, release readiness, and user communication.
• Balance short-term delivery needs with long-term product scalability and maintainability.

Cross-Functional Collaboration:

• Work closely with Engineering, Design, QA, Data/Analytics, Architecture, Implementation, Support, Operations, Product Marketing, Sales, Customer Success, Finance, Legal, Privacy, Security, and leadership stakeholders.
• Bring teams into problem-solving early rather than handing off fully formed solutions late.
• Communicate priorities, trade-offs, decisions, risks, dependencies, progress, and release readiness clearly.
• Manage stakeholder expectations with transparency and credibility.
• Influence without authority across teams and functions.
• Partner with go-to-market teams to ensure product capabilities are positioned clearly and supported with the right enablement, proof points, and customer-facing context.

Launch, Adoption & Continuous Improvement

• Ensure product capabilities are ready not only for release, but also for adoption, support, measurement, and scale.
• Partner with relevant teams on launch readiness, documentation, enablement, customer communication, support workflows, and feedback loops.
• Monitor product performance after launch and drive improvements based on data and feedback.
• Identify adoption blockers, usability issues, operational pain points, and support trends.
• Use post-launch learnings to refine roadmap priorities and improve future product decisions.
• Own outcomes beyond delivery; success is measured by whether the product solves the problem and delivers value.

Eligibility

Required Qualifications:

• 10+ years of overall professional experience, with 5+ years in Product Management, Product Owner, Lead Business Analyst, or similar product-focused roles.
• Proven experience owning complex product initiatives end-to-end.
• Experience in U.S. healthcare, payer/provider workflows, claims, payment integrity, payment accuracy, revenue cycle, clearinghouse, health-tech, or another complex regulated B2B/SaaS domain.
• Strong ability to translate ambiguous business and customer problems into clear product outcomes, requirements, priorities, and execution plans.
• Strong Agile/Scrum experience, including roadmap planning, backlog management, user stories, acceptance criteria, sprint collaboration, release planning, and stakeholder communication.
• Ability to work with engineering teams on technical workflows, APIs, data flows, rule logic, integrations, dependencies, and trade-offs.
• Strong data orientation and ability to define metrics, interpret data, validate hypotheses, and measure product impact.
• Excellent written and verbal communication skills.
• Strong stakeholder management skills across technical, business, operational, and leadership audiences.
• Ability to operate with autonomy, urgency, accountability, and sound judgement.
• Comfortable working with distributed teams across India and U.S. time zones.

Preferred Qualifications:

• Experience with claims editing, payment integrity, payment accuracy, denial prevention, claim validation, payer operations, provider workflows, EDI/X12, or healthcare APIs.
• Experience with platform products, workflow products, SaaS products, developer-facing APIs, analytics products, or operational tooling.
• Exposure to AI-assisted workflows, automation, agentic tools, or process optimisation.
• Experience defining product metrics, dashboards, ROI models, customer-value frameworks, or operational efficiency measures.
• Familiarity with Jira, Confluence, SQL, Power BI, QuickSight, Pendo, Postman, Swagger/OpenAPI, or similar product, data, and API tools.
• Experience working with global or distributed engineering teams.
• Experience supporting product marketing, sales enablement, customer success, pricing, packaging, or enterprise product launches.
• Experience in regulated environments where reliability, auditability, privacy, security, and operational readiness are important.

Key Skills:

• Product judgement and prioritisation
• Customer empathy and workflow thinking
• U.S. healthcare domain understanding or strong ability to ramp quickly
• Claims, payment integrity, or payment accuracy knowledge
• Structured product discovery
• Requirements clarity and documentation discipline
• Data fluency and ROI thinking
• Technical fluency with APIs, data, rules, and workflow systems
• AI and automation awareness
• Stakeholder management
• Influence without authority
• Cross-functional execution
• Clear communication and storytelling
• Risk identification and mitigation
• Operational readiness and supportability
• Outcome ownership

Traits We Are Looking For

• High ownership: Takes accountability for outcomes and does not wait for perfect direction.
• Customer obsessed: Understands the real user problem and advocates for customer value.
• Outcome driven: Focuses on measurable impact, not just activity or feature delivery.
• Structured thinker: Breaks ambiguity into clear problems, options, trade-offs, decisions, and next steps.
• Technically credible: Can work effectively with engineering on APIs, data, logic, workflows, and edge cases.
• Data driven: Uses evidence, metrics, and insights to guide product decisions.
• Strong communicator: Explains complex topics clearly to both technical and non-technical audiences.
• Collaborative leader: Builds trust across functions and influences without authority.
• Curious and fast-learning: Quickly ramps on complex healthcare, operational, and technical domains.
• Comfortable with ambiguity: Makes progress even when information is incomplete.
• AI-aware: Uses AI and automation as accelerators while applying human judgement and validation.
• Commercially minded: Understands how product decisions connect to revenue, cost reduction, customer retention, and market differentiation.
• Quality focused: Cares about reliability, usability, supportability, and long-term scalability.

What Success Looks Like:

• Product capabilities are delivered with clear problem definition, strong requirements, measurable outcomes, and cross-functional alignment.
• Stakeholders have confidence in product priorities, decisions, communication, and follow-through.
• Requirements, stories, and acceptance criteria are clear, validated, and ready before development begins.
• Payment accuracy workflows become faster, clearer, more scalable, and less dependent on manual effort.
• Product decisions improve claim accuracy, reduce rework, improve turnaround time, and create measurable customer value.
• Analytics and ROI insights are used to support product decisions, customer conversations, and business outcomes.
• AI and automation are used responsibly to improve efficiency, quality, and speed to value.
• Engineering, QA, Design, Implementation, Support, Operations, Sales, Marketing, Customer Success, and leadership understand priorities, trade-offs, risks, and progress.
• Customers and internal teams experience clearer communication, better product quality, stronger reliability, and improved outcomes.

Video Camera Usage:

Availity fosters a collaborative and open culture where communication and engagement are central to our success. As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.

Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.