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Oracle · 6 days ago

Principal Product Manager, Healthcare Payer Strategy

United States

Full-time

Remote

Lead/Staff

$82K/yr - $210K/yr

6+ years exp

Oracle is seeking a strategic Product Manager to define and drive its healthcare payer strategy in the United States. This role involves shaping the roadmap and go-to-market strategy for Oracle's healthcare payer solutions while collaborating with various stakeholders to meet the changing needs of the U.S. healthcare market.

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No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Define and help execute the product strategy and go-to-market vision for Oracle Health's healthcare payer solutions in the United States

Serve as a trusted advisor and product strategist for executive stakeholders at health plans, managed care organizations, government payers, and other healthcare organizations

Engage with prospective and existing customers to articulate Oracle Health's strategic vision and demonstrate the business value of our healthcare payer platform

Analyze healthcare market trends, competitive dynamics, regulatory developments, and emerging business models to identify strategic product opportunities

Influence product roadmap priorities across payer solution domains including claims adjudication, interoperability, analytics, contract management, benefit plan administration, provider reimbursement, and value-based care automation

Partner with product development and engineering teams to ensure strategic priorities are reflected in product investments and platform capabilities

Collaborate with sales, consulting, implementation, and customer success organizations to support strategic customer engagements and market growth initiatives

Develop business cases and strategic recommendations that support product investment decisions and market expansion opportunities

Represent Oracle Health at industry events, customer forums, advisory boards, and executive briefings

Establish and maintain relationships with industry thought leaders, healthcare organizations, regulatory stakeholders, and strategic partners

Provide strategic guidance and mentorship to product managers working within specific payer solution domains

Qualification

U.S. healthcare payer operationsHealthcare claims adjudicationProvider reimbursementBenefit administrationPayer analyticsHealthcare interoperabilityValue-based care programsHealthcare utilization managementPrior authorization workflowsHealthcare product managementHealthcare consultingHealthcare technology strategyCMS Interoperability and Prior Authorization Final RuleFHIRHealthcare analyticsPopulation healthRisk adjustmentPayment integrityCare management solutionsValue-based payment modelsACOBundled paymentsShared savings arrangementsCapitationGenerative AIAI technologiesHealthcare technology modernizationDigital transformationExecutive communicationStakeholder management

Required

Deep expertise in U.S. healthcare payer operations and business processes

Strong understanding of healthcare claims adjudication, provider reimbursement, benefit administration, payer analytics, interoperability, and value-based care programs

Strong understanding of healthcare utilization management, prior authorization workflows, and the operational interactions between authorization, claims adjudication, provider reimbursement, and medical management processes

Experience working with healthcare payer operations related to utilization management, care management, prior authorization, claims administration, or provider operations

Experience in product management, healthcare consulting, payer operations leadership, healthcare technology strategy, or a related role

Demonstrated success developing product strategy, market strategy, or business transformation initiatives within healthcare payer organizations

Strong executive communication, presentation, and stakeholder management skills

Experience engaging with senior leaders and executive decision-makers within healthcare organizations

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 working with commercial health plans, Blues plans, Medicare Advantage organizations, Medicaid managed care organizations, or government healthcare programs

Experience with prior authorization platforms, utilization management systems, care management solutions, or provider engagement technologies

Knowledge of CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) and emerging industry standards supporting electronic prior authorization workflows

Knowledge of healthcare interoperability standards and regulatory programs, including FHIR and CMS interoperability requirements

Experience with healthcare analytics, population health, quality measurement, risk adjustment, payment integrity, and care management solutions

Knowledge of value-based payment models and reimbursement methodologies, including ACOs, bundled payments, shared savings arrangements, and capitation

Understanding of healthcare benefit configuration, contract modeling, network management, and provider reimbursement strategies

Demonstrated expertise in leveraging generative AI and advanced AI technologies to support market analysis, strategic planning, customer engagement, product innovation, and decision-making

Proven ability to identify opportunities for AI-enabled transformation across healthcare payer operations and technology platforms

Experience supporting large-scale healthcare technology modernization or digital transformation initiatives

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