IKS Health · 1 month ago
Product SME – Referral Management and Patient Access
United States
Full-time
Hybrid
Senior Level, Lead/Staff
$90K/yr - $125K/yr
8+ years expIKS Health is a company that reduces administrative, clinical, and operational burdens in healthcare to enable staff to focus on delivering exceptional care. The Product SME – Referral Management & Patient Access is responsible for bridging healthcare operations and technology implementation, ensuring clients successfully transition their referral and patient access workflows into the product ecosystem.
Health CareMedical
Responsibilities
Engage with client stakeholders across clinical, financial, and IT functions to understand current referral and access workflows
Conduct detailed gap analyses between the client’s current systems and the target environment
Map existing processes such as referral routing, eligibility verification, prior authorization, and patient liability estimation to product capabilities
Recommend best-practice configurations and workflows based on client goals and constraints
Define functional architectures and create solution blueprints showing how requirements are met within the product
Provide advisory support to improve operational efficiency, compliance, and patient experience
Translate business and payer requirements into clear functional specifications for implementation teams
Validate configurations and integrations to ensure alignment with solution design
Represent both the 'voice of the product' and the 'voice of the customer' throughout implementation
Maintain deep knowledge of product capabilities related to referral management, coverage verification, benefit estimation, and authorization management
Serve as an internal and external subject matter expert, supporting pre-sales, implementation, and customer success teams
Provide training and enablement materials for complex product features
Help clients visualize the end-state solution and understand its business impact
Partner with change management teams to support user adoption and process redesign
Advise on continuous improvement opportunities post-go-live
Partner closely with Product Managers to share client insights and feature feedback
Work with Functional Implementation and Integration teams to ensure consistency across configurations
Support Sales and Pre-Sales teams by articulating product value and solution feasibility
Review testing outcomes and validate use-case coverage before go-live
Support User Acceptance Testing (UAT) and sign off on functional readiness from a product perspective
Qualification
Required
8+ years in healthcare operations, technology, or consulting, focusing on referral management, patient access, eligibility/benefits, or prior authorization
Hands-on experience implementing or configuring solutions such as Epic, Cerner, Experian, Availity, or similar
Familiarity with payer transactions (X12 270/271, 278), interoperability standards (HL7, FHIR), and healthcare data exchange processes
Bachelor's degree in Healthcare Administration, Informatics, Computer Science, or related field
Preferred
Master's degree in Healthcare Administration, Informatics, Computer Science, or related field
Benefits
Healthcare
401 (k)
Paid time off
Company
IKS Health
IKS Health offers clinical, financial, and administrative healthcare solutions.
10001+ employees
H1B Sponsorship
IKS Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (7)
2023 (4)
2021 (5)
2020 (3)
Funding
Current Stage
Public CompanyTotal Funding
unknown2024-12-19IPO
2006-11-16Seed
Leadership Team
Sachin Gupta
Founder & CEO
Joe Benardello
Co-founder and Chief Growth Officer
Recent News
2026-01-16
2025-11-23
Company data provided by crunchbase