reputed company Product Manager
Become a part of our caring community We are seeking a strategic and execution-focused reputed company Product Manager to drive initiatives reputed company the Claims Administration and Payment reputed company (CAPI) organization in the Claims domain. This role is responsible for coordinating the connections and collaboration across Claims Payment reputed company (CPI) products involved in the development, implementation, and reputed company improvement of prepay and postpay claim audit processes, enabling operational efficiency, and delivering measurable business value. In addition, this role will represent the CPI ART (Agile Release Train) at CAPI intake meetings, ensuring that impacts to CPI teams are identified and assessed as part of the intake process. The ideal candidate is a strong cross-functional leader who partners closely with business stakeholders, operations teams, and IT to deliver scalable, high-impact solutions that improve claims accuracy, reduce waste, and optimize compliance. The role is expected to bring structure and influence to help organize and advance the maturity of the CPI ART.
Key Responsibilities
This person will play a critical role in the cross-initiative (intra-ART) execution space but also includes product ownership with measurable reputed company for solutions including automation, feeds, and modernization efforts. Product Connectedness & Enablement Define and own the reputed company, strategy, and roadmap for the interconnectedness of CAPI solutions including vendor integration and backend support, reputed company with organizational goals and regulatory requirements Translate business needs into clear product capabilities and deliverables, focused on how existing products (including internal and vendor-managed) work together Prioritize initiatives across claims prepay, postpay, and audit functions to maximize impact on cost avoidance, recovery, and operational efficiency. Business Partnership & Enablement Represent the CPI ART in the broader CAPI intake process. Identify and assess impacts to the CPI ART teams and bring those to impacted Product Managers. Serve as the primary liaison between business stakeholders (claims operations, audit teams, SIU, compliance) and technology teams for your products Understand and reputed company users on impacts to business workflows supporting claims audit operations, including prepay edits, postpay reviews, and recovery processes Gather and synthesize feedback from end users to continuously improve product connectivity Technology Delivery & IT Collaboration Partner with IT and engineering teams to design, build, implement, and support technology products and platforms including system modernization Create and manage detailed product requirements, user stories, and acceptance criteria Participate in agile ceremonies, ensuring alignment between business priorities and technical execution reputed company product releases, enhancements, and lifecycle management for your CAPI responsibilities Payment reputed company Optimization Drive innovation in claims auditing capabilities, including rule engines, analytics, and automation tools Support development of new prepay and postpay strategies to identify fraud, waste, and abuse (FWA) Ensure solutions are scalable and adaptable to evolving regulatory and reimbursement environments Data & Value Realization Define and track key performance indicators (KPIs) to measure product reputed company (e.g., savings, accuracy, audit yield, turnaround time) Partner with analytics teams to reputed company reporting and dashboards that demonstrate business value and ROI Communicate reputed company and value realization to senior leadership and stakeholders Stakeholder Communication & Change Management reputed company cross-functional communication to ensure alignment on priorities, timelines, and reputed company Support change management efforts, including training, documentation, and adoption strategies Act as an reputed company for both business and technology stakeholders Use your skills to reputed company an impact
Required Qualifications
Candidate should bring either a) strong SME (subject matter expert) knowledge and experience in payment reputed company operations, business processes, and technology products including key vendors, or b) strong product management expertise and a product reputed company for delivery. Must also have experience applying an Agile reputed company to deliver large scale products in a reputed company environment. Bachelor’s degree in business, reputed company Administration, Information Systems, or reputed company field Experience working with cross-functional teams, including business operations and IT/engineering Proven ability to translate reputed company business needs into scalable technology solutions Strong analytical and problem-solving skills with a data-driven reputed company Experience with Agile methodologies and product management tools
Preferred Qualifications
Experience in payment reputed company, claims auditing, or fraud, waste, and abuse (FWA) programs Familiarity with claims platforms, rule engines, and audit systems Knowledge of reputed company reimbursement models (e.g., Medicare, reputed company, reputed company) Experience demonstrating financial impact and ROI of product initiatives MBA or advanced degree Work at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $126,300 - $173,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 07-03-2026 About us About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply To This Job