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NetSuite · 1 month ago

Senior Product Manager, Healthcare Payer Strategy

United States

Full-time

Remote

Senior Level

$75K/yr - $187K/yr

3+ years exp

NetSuite is seeking a Product Manager to drive the expansion of Oracle's healthcare claims adjudication platform for the United States market. This role will focus on defining and delivering capabilities to meet the unique business, operational, and regulatory requirements of the U.S. healthcare system, acting as the product owner and engaging with stakeholders to translate market needs into product requirements.

AccountingCloud ComputingElectronicsEnterprise SoftwareAppsSaaSSoftwareComputerCRMEnterprise Resource Planning (ERP)iOS

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Serve as the product domain expert for U.S. healthcare claims adjudication capabilities

Engage with prospective and existing customers to demonstrate product functionality and communicate the value of Oracle's claims adjudication platform

Conduct customer workshops, discovery sessions, and requirements-gathering activities to understand claims processing workflows, business rules, and operational challenges

Translate customer needs into product requirements, user stories, functional specifications, and other product management artifacts

Collaborate closely with engineering teams to define solution designs and clarify business requirements throughout the development lifecycle

Support development teams by providing healthcare claims adjudication expertise and validating proposed solutions

Analyze market requirements and identify product enhancements needed to support U.S. healthcare payer operations

Contribute to product roadmap planning and prioritization for U.S.-specific capabilities

Partner with implementation, consulting, sales, and customer success teams to support customer adoption and successful deployments

Monitor industry trends, reimbursement models, and regulatory developments that may impact claims adjudication processes and product requirements

Act as a trusted advisor to internal stakeholders on U.S. healthcare claims processing and adjudication practices

Qualification

U.S. healthcare industry knowledgeFee-for-service claims adjudicationHealthcare payer operationsClaims administrationClaims adjudication systemsPayment integrityReimbursement methodologiesProduct managementBusiness analysisHealthcare consultingRequirements gatheringFunctional specificationsHealthcare claims standardsX12 claims processingValue-based payment modelsAccountable Care Organizations (ACOs)Bundled paymentsShared savings arrangementsPay-for-performance programsCapitationAgile software developmentAI technologiesStakeholder management

Required

Deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes

Experience with healthcare payer operations, claims administration, claims adjudication systems, payment integrity, reimbursement, or related healthcare technology solutions

Experience in product management, business analysis, healthcare consulting, payer operations, or a related role

Proven ability to gather, document, and prioritize complex business and functional requirements

Strong customer-facing, presentation, and stakeholder management skills

Experience working directly with healthcare payers, health plans, third-party administrators, or healthcare technology vendors

Ability to translate complex claims processing requirements into software capabilities and functional solution designs

U.S. citizenship is required for this position, as the successful candidate will be required to obtain and maintain a U.S. government security clearance after hire

Preferred

Experience with commercial, Medicare, Medicaid, or government healthcare programs

Familiarity with healthcare claims standards and transactions, including X12 claims processing and related industry standards

Knowledge of value-based payment models and reimbursement methodologies, including Accountable Care Organizations (ACOs), bundled payments, shared savings arrangements, pay-for-performance programs, capitation, and other alternative payment models

Experience working in Agile software development environments

Knowledge of modern claims platforms, payment integrity solutions, utilization management systems, care management platforms, or core administration systems

Proven ability to use AI technologies to improve productivity, enhance decision-making, synthesize complex information, identify product opportunities, and strengthen collaboration across customers, product teams, and engineering organizations

Strong interest in emerging AI capabilities and a track record of evaluating and applying AI-driven approaches to solve business problems, improve operational efficiency, and drive innovation within healthcare technology environments

Benefits

May be eligible for bonus and equity.

Medical, dental, and vision insurance, including expert medical opinion

Short term disability and long term disability

Life insurance and AD&D

Supplemental life insurance (Employee/Spouse/Child)

Health care and dependent care Flexible Spending Accounts

Pre-tax commuter and parking benefits

401(k) Savings and Investment Plan with company match

Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.

11 paid holidays

Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.

Paid parental leave

Adoption assistance

Employee Stock Purchase Plan

Financial planning and group legal

Voluntary benefits including auto, homeowner and pet insurance