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Product Owner / Solution Architect – Provider Data & Data Quality- REMOTE

Work from home Full-time role Hiring

Job Summary We are seeking a strategic and execution-oriented Product Owner / Solution Architect with deep health plan provider data expertise to lead the product strategy, roadmap execution, and cross-functional delivery of a modern provider data platform. This role will own the end-to-end product lifecycle for the organization's provider data ecosystem — establishing a scalable "system of truth,” driving API-enabled modernization, and implementing a formal provider data quality and governance program. The ideal candidate combines strong product management discipline, program execution leadership, and solution architecture depth within complex payer environments. Primary Responsibilities Product Strategy & Roadmap Ownership

  • Define and own the multi-quarter product roadmap for provider data modernization
  • Prioritize initiatives based on business value, risk reduction, automation impact, and regulatory requirements
  • Establish KPIs for provider data accuracy, reconciliation cycle time, API adoption, and platform utilization
  • Manage backlog, define epics and user stories, and support Agile delivery cycles
  • Drive stakeholder alignment and executive visibility into roadmap progress

Platform Modernization & Integration Leadership

  • Establish the provider data platform as the enterprise system of record / system of truth
  • Lead the transition from manual and batch-based processes to API-driven integrations
  • Define integration strategy across CAQH, Symplr, Cactus, Facets, and downstream systems
  • Partner with engineering to define technical requirements and scalable architecture patterns
  • Evaluate system handoffs and eliminate integration gaps across credentialing and core administration platforms

Provider Data Domain & Workflow Optimization Apply deep understanding of health plan provider workflows including:

  • Credentialing
  • Contracting
  • Provider enrollment
  • Directory management
  • Roster reconciliation
  • Downstream data distribution
  • Map current-state workflows and define future-state optimized models
  • Identify automation opportunities that reduce manual reconciliation and operational risk
  • Standardize data flows across credentialing and core administrative systems

Data Quality & Governance Program Leadership

  • Design and implement a formal Provider Data Quality Framework
  • Define measurable data quality KPIs (accuracy, timeliness, completeness, reconciliation variance)
  • Establish validation rules, monitoring dashboards, and escalation workflows
  • Improve and scale weekly reconciliation processes
  • Create governance standards across source systems and downstream consumers
  • Ensure alignment and consistency across CAQH, Symplr, Cactus, Facets, and the provider data platform
  • Build durable documentation for both manual and automated processes

Cross-Functional Delivery & Program Leadership

  • Act as the primary liaison between operations, credentialing, provider network, IT, and engineering
  • Drive structured intake, prioritization, and delivery governance processes
  • Distribute work across project teams and ensure alignment with overall product strategy
  • Provide architectural oversight for API and development initiatives
  • Potentially serve as U.S.-based functional/technical lead for expanding API and engineering capabilities
  • Drive adoption and change management across business stakeholders

Education and Experience

  • 8+ years in health plan operations, provider data management, payer IT, or healthcare product environments
  • Proven experience in Product Owner, Product Manager, Program Manager, or Solution Architect roles
  • Deep expertise in provider data lifecycle management
  • Hands-on experience with: CAQH, Facets, Cactus, Symplr Payer
  • Experience leading cross-functional product initiatives from strategy through delivery
  • Experience improving provider data accuracy and reconciliation processes
  • Experience modernizing integrations (batch to API transitions)
  • Strong understanding of provider data integration patterns and API architecture
  • Experience building and managing product roadmaps and backlogs
  • Ability to translate complex business workflows into structured technical requirements
  • Experience designing system-of-truth and data governance frameworks
  • Familiarity with compliance and provider directory regulatory requirements
  • Experience working with distributed engineering teams in Agile environments

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