Job Description

HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.

About This Role

HealthEdge is seeking a Product Manager, HRP Artificial Intelligence to lead the AI strategy and product vision for HealthRules® Payer – our flagship core administrative processing platform. This is a high-impact, cross-functional role at the intersection of product strategy, AI innovation, and healthcare payer operations. You will define how AI capabilities are woven across the full breadth of HRP value streams – from claims adjudication and member management to benefit configuration, enrollment, and contract management – while partnering closely with HealthEdge’s AI Platform and engineering leadership to bring those capabilities to market.

The Product Manager, HRP Artificial Intelligence owns the AI product strategy for HealthRules® Payer. This role is responsible for identifying, defining, and driving the adoption of AI capabilities that create measurable value for health plans across the full HRP platform. You will develop the overarching AI strategy, establish a prioritized AI roadmap, and serve as the primary product voice for AI initiatives spanning all HRP value streams.

You will partner directly with HealthEdge’s AI Platform leadership on strategy alignment, AI model development, and go-to-market positioning – ensuring that AI product development is grounded in real customer workflows, regulatory requirements, and operational outcomes.

Key Responsibilities

AI Strategy & Roadmap

• Define and maintain the comprehensive AI product strategy for HealthRules® Payer, aligned with corporate AI vision and market direction

• Build and prioritize the HRP AI roadmap across value streams: Claims, Member Management, Enrollment, Benefit Configuration, and Contract Management

• Identify high-value AI use cases through customer discovery, market analysis, and internal stakeholder collaboration

• Establish success metrics and KPIs for AI feature adoption, operational improvement, and customer outcomes

• Translate AI strategy into clear product requirements, epics, and roadmap themes for engineering execution

Cross-Functional AI Leadership

• Serve as the primary product counterpart to HealthEdge’s AI Platform and engineering leadership team for all HRP AI initiatives

• Partner with value stream Product Managers (Claims, Member, Enrollment, Benefits, Contracts) to embed AI capabilities within their roadmaps

• Collaborate with UX, engineering, data science, and architecture to ensure AI features meet usability, compliance, and performance standards

• Drive alignment across product, engineering, and go-to-market teams on AI product launches and release readiness

• Represent HRP AI product capabilities in executive reviews, customer briefings, and industry forums

AI Messaging & Go-to-Market

• Develop compelling AI product narratives, positioning, and messaging in partnership with Marketing and Sales

• Create and maintain AI-focused product collateral including feature overviews, customer presentations, and competitive differentiation materials

• Support customer-facing AI demonstrations, proof-of-concept engagements, and pilot programs

• Articulate the AI product vision at conferences, customer advisory boards, and analyst briefings

Product Governance & Compliance

• Ensure all AI capabilities meet applicable regulatory and compliance requirements, including CMS guidelines, HIPAA, and evolving AI governance standards

• Establish guardrails for responsible AI use within healthcare payer workflows – particularly ensuring deterministic adjudication integrity is preserved

• Monitor emerging AI regulations and assess impact on the HRP AI product strategy

• Maintain a clear distinction between AI-assisted operational tools and the core adjudication engine, consistent with HealthEdge’s AI governance philosophy

Required Qualifications

• 7+ years of product management experience, with at least 3 years in healthcare payer administration technology or a closely related domain

• Demonstrated experience defining and delivering AI, machine learning, or intelligent automation products in enterprise software environments

• Deep understanding of healthcare payer operations including claims adjudication, member management, benefit configuration, enrollment, and/or contract management

• Strong grasp of AI/ML concepts and the ability to translate technical capabilities into customer-facing value propositions

• Proven ability to drive cross-functional roadmap alignment across product, engineering, and go-to-market teams

• Experience developing product strategy documents, business cases, and executive-level presentations

• Exceptional communication skills – able to articulate complex AI concepts clearly to both technical and non-technical audiences

• Bachelor’s degree in Computer Science, Business, Healthcare Administration, or a related field; or equivalent experience

Preferred Qualifications

• Experience with HealthRules® Payer or comparable core administrative processing systems

• Background in LLM-based product development, agentic AI workflows, or AI product operations

• Experience with clinical or operational AI applications in managed care or payer BPaaS environments

• Prior work in a product-led SaaS company with a focus on AI feature commercialization

• MBA or advanced degree in a relevant discipline

What Success Looks Like

In your first 90 days:

• Completed a current-state assessment of all AI capabilities within HRP and adjacent HealthEdge products

• Established relationships with AI Platform engineering leadership, value stream PMs, and key customer stakeholders

• Delivered an initial HRP AI strategy framework and roadmap proposal to executive leadership

Within six months:

• AI roadmap is integrated into HRP product planning cycles with clear ownership and engineering alignment

• AI messaging and positioning materials are available for Sales and Marketing use

Within one year:

• Multiple AI features shipped across HRP value streams with measurable customer adoption

• HRP AI strategy recognized by customers and analysts as a competitive differentiator

• Established HealthEdge as a credible, responsible AI innovator in the healthcare payer technology market

Geographic Responsibility: Remote, US

Type of Employment: Full-time, permanent

FLSA Classification (USA Only): Exempt

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job: 

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

• Work across multiple time zones in a hybrid or remote work environment.

• Long periods of time sitting and/or standing in front of a computer using video technology.

• May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.

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**The annual US base salary range for this position is $132,000 to $141,000 This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.