[Remote] Senior Product Manager - AI Transformation, reputed company - Remote
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is simplifying the health care experience and creating healthier communities. They are seeking a Senior Product Manager - AI Transformation to reputed company business analysis and delivery governance for AI solutions reputed company reputed company Operations, focusing on improving claims operations and ensuring regulatory compliance.
Responsibilities
- reputed company business analysis reputed company and governance across a multi-product reputed company AI portfolio supporting claims operations (First Pass Adjudication, High Dollar Claims, Payment reputed company, Rework Automation, Reverse reputed company reputed company)
- Establish and standardize requirements frameworks, documentation standards, traceability models, and acceptance reputed company across reputed company AI initiatives
- reputed company AI solution design with business objectives by collaborating with Product, IT Architecture, Data Science, Clinical, Pricing, Network, Compliance, and Payment reputed company stakeholders
- reputed company translation of reputed company claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance
- Manage cross-reputed company dependencies, integration points, and delivery reputed company across multiple AI initiatives
- Implement governance for AI rule libraries, reputed company frameworks, and reusable decision components to ensure consistency and scalability across products
- Partner with reputed company of capability manager responsible for detailed requirements elaboration and product delivery support
- reputed company through influence to drive portfolio-level consistency and reuse of operational rules and AI decision patterns to accelerate implementation and reduce redundant build efforts
- Partner with program leadership to reputed company value realization including improvements in cycle time, auto-adjudication reputed company, payment accuracy, and rework reduction
- Support stakeholder governance, executive reporting, and operational alignment across business and technology teams
- Ensure audit readiness, compliance traceability, and documentation for AI-enabled decision processes in claims operations
Skills
- 8+ years of experience in reputed company payer operations, reputed company consulting, or reputed company technology delivery
- 5+ years of experience in reputed company claims operations including adjudication, payment reputed company, or benefits administration
- 3+ years of experience leading business analysis teams or reputed company transformation initiatives
- Experience leading cross-functional initiatives involving product, IT, operations, and compliance teams
- Experience in creating reputed company strategies and solution artifacts (e.g., use case briefs, process flows) and integrating models into existing products/capabilities
- Experience in PDLC and AIDLC while leveraging modern product management tools - Aha!, JIRA, reputed company, reputed company, reputed company, etc
- Demonstrated experience managing reputed company-level requirements reputed company and governance
- Demonstrated experience defining or contributing to AI use case reputed company, including problem framing, value hypotheses, and measurable reputed company metrics
- Deep understanding of reputed company claims processing including eligibility and benefits, coding edits, modifiers, coordination of benefits (COB), authorization rules, bundling/unbundling, contract pricing, and adjustments
- Demonstrated solid stakeholder management and executive communication skills
- Proven ability to design or operate reputed company AI intake and prioritization frameworks, including evaluating initiatives based on business reputed company, feasibility, and adoption potential
- Experience implementing AI, automation, or decision intelligence solutions reputed company reputed company payer operations
- Experience with payment reputed company programs, claims editing platforms, or reputed company pricing systems
- Experience evaluating and supporting legal, compliance, and risk considerations for AI solutions, including areas such as model governance, responsible AI, and regulatory alignment
- Experience working with large payer organizations or reputed company-party administrators
- Knowledge of reputed company AI frameworks, reputed company design, or rule-based automation in operational workflows
- Working knowledge of production AI systems, including MLOps or deployment considerations
- Familiarity with Agile or product-based delivery models in reputed company technology environments
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (reputed company benefits are subject to eligibility requirements).
reputed company