Easter Seals Jobs

Edifecs

Product Manager - Prior Authorization

Overview

We are seeking a highly skilled Product Manager to lead the development and management of our Prior Authorization products at Edifecs. This role involves driving various initiatives, collaborating with providers and payers, and ensuring our products meet industry standards and customer needs. As a key member of our team, you will be responsible for defining product requirements, conducting market analysis, and leading customer success initiatives. Your expertise will help shape the future of our products and enhance our position as a leader in the healthcare technology industry.

What you will do:

• Collaborate with Providers and Payers to collect requirements related to Prior Authorization and Utilization Management.
• Participate in industry events and support industry groups focused on Prior Authorization implementation.
• Define and document requirements for Edifecs Prior Authorization products.
• Perform research and market analysis to identify features and enhancements.
• Communicate product specifications and updates to customers.
• Coordinate with cross-functional teams to develop product specifications and business architecture.
• Evaluate information from multiple sources to reconcile conflicts and refine user needs.
• Lead customer success initiatives and gather product usability feedback.
• Ensure compliance with company policies and procedures.

What you will bring:

• Bachelor's or Master's degree in Engineering or related field, or equivalent experience in analysis or healthcare. Certification in Business Analysis (CBAP) and/or Healthcare (AHM 250) is a plus.
• 5-10 years experience as a Systems Analyst or Product Manager.
• Hands-on experience with Provider Prior Authorization and/or Payer Utilization management business processes.
• Strong understanding of the Payer and Provider revenue cycle, billing, and care management.
• Experience in designing and/or architecting Cloud Services.
• Proficiency with SaaS products, containerization, multi-tenancy, data security, and privacy.
• Knowledge of EDI transactions such as HIPAA x12, HL7, EDIFACT, NCPDP, and FHIR.
• Familiarity with the Prior Authorization IG by DaVinci and/or CodeX is a plus.
• Experience with Agile processes, writing user stories, wireframing, and defining requirements.
• Proven ability in product development and management from conceptualization to implementation.
• Exposure to the US Healthcare Insurance domain.
• Experience working with Sales, Marketing, Implementation, Support, and other teams.
• Strong analytical skills and ability to translate customer business needs into application requirements.
• Experience in testing and user acceptance test planning for large enterprise systems.
• Demonstrated understanding and application of company policies and procedures.

Note:

• Expected base pay range: $112,096 - $164,407 per year, depending on location, knowledge, education, and experience.
• Comprehensive well-being plan including medical, dental, vision, life, and disability insurance.
• 401(k) retirement savings plan with Edifecs matching contribution.
• Up to 25 days of PTO and 10 holidays per year.
• Additional well-being offerings available.

About Edifecs:

Edifecs is a premier technology company in the U.S. healthcare market, focusing on interoperability, workflows, risk adjustment, value-based care payments, and analytics. Our solutions optimize the secure exchange and processing of administrative and clinical data, reduce regulatory compliance costs, and automate core healthcare processes. Edifecs is a leader in B2B data exchange, FHIR, and new regulatory compliance. We offer solutions in O