Lead Product Manager, Claims and Eligibility Job at Spring Health (New York City)

Senior Product Manager, Data Ingestion & Care Enablement

As a Senior Product Manager on our Data Ingestion & Care Enablement (DICE) team,...

Location

United States

Salary:

148750.00 - 175000.00 USD / Year

Thyme Care

Expiration Date

Until further notice

Requirements

4+ years of experience in product management, data operations, or a related role within healthcare
Direct experience working with healthcare claims data, eligibility files, and value-based care data in a payer, provider, or health tech environment
Track record of managing complex data integrations or implementations with external partners
Experience collaborating closely with data science and data engineering teams
comfortable with SQL and working in data-heavy environments
Proven ability to manage competing priorities across multiple partners and internal stakeholders simultaneously
Strong written and verbal communication skills, with the ability to translate technical concepts for non-technical audiences and vice versa
Experience operating effectively in ambiguous, fast-moving environments where you had to define the path forward

Job Responsibility

Own partner data integrations end-to-end: lead implementations with payers and providers, managing data ingestion, quality, enrollment logic, and return files from kickoff through go-live and ongoing operations
Serve as a primary point of contact for external data counterparts: negotiate data specifications, troubleshoot issues, and build strong working relationships with partner organizations
Translate technical complexity into business clarity: break down intricate data and integration challenges into actionable requirements that product, engineering, and data science teams can execute against
Drive cross-functional alignment: coordinate across DICE, growth, health economics, clinical operations, and care delivery teams to ensure data-dependent initiatives stay on track
Build and maintain operational visibility: develop monitoring, dashboards, and proactive alerting so the team can shift from reactive problem-solving to proactive management of data quality and integration health
Own analyses that drive decisions: lead work on eligibility reconciliation, claims analysis, enrollment trends, and other data investigations that inform executive and operational decision-making
Shape the DICE roadmap: partner with your team lead to identify opportunities, prioritize initiatives, and drive multi-quarter projects that improve how Thyme Care acquires, processes, and leverages data
Leverage AI to accelerate your work: stay current with AI tools and capabilities, applying them where they can improve your own productivity and the effectiveness of data workflows

What we offer

Equity
Other opportunities at Thyme Care

Fulltime

Insurance staff position

Successful State Farm Agent is seeking a qualified professional to join their wi...

Location

United States , Forest

Salary:

30000.00 - 40000.00 USD / Year

State Farm Insurance Agent

Expiration Date

Until further notice

Requirements

Sales experience (outside sales or inside sales representative, retail sales associate, or telemarketing) preferred
Successful track record of meeting sales goals/quotas preferred
Excellent communication skills - written, verbal and listening
Enthusiastic about the role insurance and financial products play in helping people manage the risks of everyday life, recover from the unexpected, and realize their dreams
Self-motivated
Ability to make presentations to potential customers
Achieve mutually agreed upon marketing goals
Experience in marketing
Property and Casualty license (must have currently)
Life and Health license (must have currently)

Job Responsibility

Provide prompt, accurate, and friendly customer service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification
Use a customer-focused, needs-based review process to educate customers about insurance options
Work with the agent to establish and meet marketing goals
Develop leads, schedule appointments, identify customer needs, and market appropriate products and services

What we offer

Bonus based on performance
Competitive salary
Paid time off
Training & development
Hourly pay plus commission/bonus
Paid time off (vacation and personal/sick days)
Valuable experience
Growth potential/Opportunity for advancement within my agency

Fulltime

Technical Lead, Host Assurance

OpenAI is seeking a Technical Lead, Host Assurance to own and scale the trust fo...

Location

United States , San Francisco; Seattle

Salary:

347000.00 - 385000.00 USD / Year

OpenAI

Expiration Date

Until further notice

Requirements

Have built and scaled deeply technical security or infrastructure teams in prior roles, with direct people-management responsibility
Have led senior engineers and earned credibility through hands-on technical leadership
Have deep experience with PKI, HSMs, machine identity, host attestation, secure boot, or hardware-rooted trust
Have built and operated security-critical infrastructure that sits on the critical path for large-scale production systems
Are comfortable owning low-level, high-impact systems where correctness, reliability, and scale matter deeply
Balance rigor with pragmatism, enabling teams to move quickly without compromising foundational trust
Earn trust through delivery — building, operating, and improving systems yourself when it matters most
Are energized by ambiguous problems, rapid growth, and building infrastructure that shapes the future

Job Responsibility

Own host assurance outcomes by defining and evolving the baseline security properties required for bare-metal hosts to be eligible for production use
Ensure hosts are verifiably trustworthy from delivery and installation through secure bootstrap and readiness to join orchestration systems
Design, implement, and operate the Host Assurance platform, including: HSM-backed services and key-management infrastructure, PKI and certificate-issuance systems that eliminate static credentials, and host identity, attestation, and measurement tooling
Validate delivered hardware and firmware against vendor claims and continuously detect and manage drift over time
Eliminate insecure bootstrap patterns while preserving deployment throughput and operational reliability
Partner with provisioning, fleet, and orchestration teams to deliver paved paths where the secure approach is the easiest approach
Set and uphold a high bar for reliability, resilience, and operational hygiene across foundational trust services
Lead incident response and post-incident learning when issues arise, driving systemic improvements that keep these systems dependable at scale
Lead, mentor, and directly manage a small team of senior engineers across PKI, operating systems, hardware security, and platform engineering
Hire and scale the Host Assurance function deliberately and proportionately as OpenAI’s compute footprint and platform ambitions grow

What we offer

Medical, dental, and vision insurance for you and your family, with employer contributions to Health Savings Accounts
Pre-tax accounts for Health FSA, Dependent Care FSA, and commuter expenses (parking and transit)
401(k) retirement plan with employer match
Paid parental leave (up to 24 weeks for birth parents and 20 weeks for non-birthing parents), plus paid medical and caregiver leave (up to 8 weeks)
Paid time off: flexible PTO for exempt employees and up to 15 days annually for non-exempt employees
13+ paid company holidays, and multiple paid coordinated company office closures throughout the year for focus and recharge, plus paid sick or safe time (1 hour per 30 hours worked, or more, as required by applicable state or local law)
Mental health and wellness support
Employer-paid basic life and disability coverage
Annual learning and development stipend to fuel your professional growth
Daily meals in our offices, and meal delivery credits as eligible

Fulltime

Solution Architect, Claims Platform Migration

Platform migrations fail when the technical design doesn't align with how client...

Location

United States

Salary:

85000.00 - 105000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

Bachelor's degree in business, healthcare administration, information systems, or related field, or equivalent experience
5+ years experience in solution design, implementation, or configuration within healthcare, insurance, or TPA environment
Experience in TPA or payor environments strongly preferred
Background supporting claims platforms and digital member/employer solutions
Strong understanding of employer benefits administration systems and digital engagement platforms
Ability to conduct and document detailed gap analyses and solution designs
Proficiency in presenting and demonstrating solutions in client-facing engagements
Ability to translate technical capabilities into client-friendly language and actionable solutions
Strong analytical, problem-solving, and documentation abilities

Job Responsibility

Conduct comprehensive gap analyses: Assess differences between current-state and future-state service and digital experiences at the group level to identify solution requirements and migration challenges
Design migration solutions: Create solutions that address claims administration, eligibility, benefits configuration, data ingestion, reporting and analytics, and digital experience needs for transitioning clients
Lead solution demonstrations: Present client-facing demonstrations focused on digital portals, tools, and workflows, highlighting impact on client and member service delivery
Translate design into requirements: Partner with Business Analysts to convert solution designs into clear client requirements documentation for implementation teams
Ensure accurate execution: Collaborate with Business Analysts and Project Managers to verify solution designs are implemented accurately and meet client expectations
Identify and mitigate risks: Proactively flag risks, dependencies, and constraints within proposed solutions while recommending mitigation strategies to keep projects on track
Serve as subject matter expert: Provide expertise on claims ecosystem and digital platform capabilities while aligning solutions with product roadmap direction

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Unlimited PTO
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Revenue Cycle Management (RCM) Domain Architect

The Senior Director, Digital Solutions Architect will lead the design and implem...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

10+ years of experience in healthcare revenue cycle, consulting, or RCM operations
Deep understanding of provider RCM processes across patient access, coding, billing, denials, payment posting, and collections
Experience designing RCM architectures, target operating models, or digital transformation roadmaps for provider organizations
Strong knowledge of payer rules, CMS policies, coding standards (ICD-10, CPT, HCPCS), and compliance requirements
Familiarity with AI/ML workflows, LLM-driven automation, and digital RCM solutions (even if not hands-on technical)
Strong storytelling and client engagement skills, especially with executive healthcare stakeholders
Ability to partner with engineering and product teams to translate domain requirements into platform features

Job Responsibility

Lead architecture and design for end-to-end provider RCM, including: Patient access & scheduling, Eligibility & prior authorization, Charge capture & clinical documentation integrity, Coding (pro-fee, facility, specialty), Billing, claims processing, and submission, Denials prevention and denials management, Payment posting & reconciliation, Patient financial engagement & collections
Translate compliance, regulatory, and payer requirements (HIPAA, CMS guidelines, coding standards) into scalable AI-driven workflows
Develop reusable domain models and frameworks for provider, ASC, specialty care, and hospital revenue cycle operations
Architect modular, agentic RCM solutions using LLM-based co-pilots, autonomous denial agents, and decision-support services
Collaborate with ML, engineering, and ontology teams to define RCM ontologies, data structures, and decision models (e.g., coding logic, payer rule libraries, denial taxonomies)
Design closed-loop systems for continuous optimization across claims, payments, and workflow routing
Lead discovery sessions with provider organizations, health systems, and RCM leadership to map current-state operations and identify inefficiencies
Present AI-native RCM architectures and transformation roadmaps to CFOs, Revenue Cycle VPs, HIM leaders, and clinical operations stakeholders
Own the translation of RCM domain requirements into platform capabilities and implementation plans
Build multi-year modernization strategies that connect operational KPIs—DNFB, clean claim rate, A/R days, denial rate, cost-to-collect—to automation roadmaps

Fulltime

Director, Clinical Development

The Director of Clinical Development leads the team responsible for design, exec...

Location

United States

Salary:

165000.00 - 200000.00 USD / Year

Loyal

Expiration Date

Until further notice

Requirements

DVM or equivalent
8–12+ years of experience in clinical development in animal health clinical development
Demonstrated experience designing and leading clinical trials, including protocol authorship, data review, and cross-functional collaboration
Prior oversight of safety evaluation, study conduct, and interpretation of clinical endpoints
Strong understanding of evidence requirements for regulatory approval
Ability to lead in a fast-paced, high-accountability biotech environment
Direct experience with FDA-CVM VICH guidelines
Experience in companion animal medicine
Background working with veterinary clinics, practice networks, or decentralized trial models

Job Responsibility

Own the clinical development strategy for our portfolio of veterinary drug programs, including target product profiles, pivotal pathway planning, and key endpoints aligned with CVM expectations
Build and manage detailed timelines for product development
Communicate strategy and development timelines across multiple teams within Loyal
Design companion animal clinical trials (pilot, field safety, and pivotal effectiveness studies) with appropriate statistical powering, endpoint justification, inclusion/exclusion parameters, and handling of operational constraints
Develop protocols, investigator brochures, SAP inputs, and essential documents tailored for investigators and staff in veterinary practice settings
Work closely with statisticians on statistical design, randomization schemes, interim analyses, and data quality plans
Partner with clinical operations to execute protocols with GCP compliance and serve as medical expert throughout in-life phase
Provide medical and scientific oversight for all clinical studies, including: Eligibility decisions, Case reviews and AE/SAE reporting, Protocol deviations and issue escalation, Interpretation of clinical data trends during trial execution
Support Clinical Operations with site engagement strategy, investigator training, and owner-facing communication frameworks
Partner with Veterinary Affairs on real-world applicability, disease models, and clinician feedback loops

What we offer

Full-coverage health insurance — medical, dental and vision — for you and your dependents
$1,000 home office equipment stipend
$1,200/year learning budget for books, courses, etc.
$250/month wellness budget for gym, cleaners, spa, food, etc.
All 3-day weekends are turned into 4-day weekends
Unlimited vacation and paid holidays
Paw-ternity leave — adopt a dog and get a day off with your new family member
Competitive salary
Company equity options grant for new hires

Fulltime

Migration Solution Designer

Design migration solutions that make complex migrations feel seamless. Bridge th...

Location

United States , Tempe

Salary:

85000.00 - 105000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

Bachelor's degree in business, healthcare administration, information systems, or related field, or equivalent experience
5+ years experience in solution design, implementation, or configuration within healthcare, insurance, or TPA environment
Experience in TPA or payor environments strongly preferred
Background supporting claims platforms and digital member/employer solutions
Strong understanding of employer benefits administration systems and digital engagement platforms
Ability to conduct and document detailed gap analyses and solution designs
Proficiency in presenting and demonstrating solutions in client-facing engagements
Ability to translate technical capabilities into client-friendly language and actionable solutions
Strong analytical, problem-solving, and documentation abilities

Job Responsibility

Conduct comprehensive gap analyses: Assess differences between current-state and future-state service and digital experiences at the group level to identify solution requirements and migration challenges
Design migration solutions: Create solutions that address claims administration, eligibility, benefits configuration, data ingestion, reporting and analytics, and digital experience needs for transitioning clients
Lead solution demonstrations: Present client-facing demonstrations focused on digital portals, tools, and workflows, highlighting impact on client and member service delivery
Translate design into requirements: Partner with Business Analysts to convert solution designs into clear client requirements documentation for implementation teams
Ensure accurate execution: Collaborate with Business Analysts and Project Managers to verify solution designs are implemented accurately and meet client expectations
Identify and mitigate risks: Proactively flag risks, dependencies, and constraints within proposed solutions while recommending mitigation strategies to keep projects on track
Serve as subject matter expert: Provide expertise on claims ecosystem and digital platform capabilities while aligning solutions with product roadmap direction

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Unlimited PTO
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

People Experience and Operations Senior Associate (Medical Services)

The People Operations Coordinator will be responsible for overseeing and executi...

Location

Egypt , New Cairo

Salary:

Not provided

Pepsico

Expiration Date

Until further notice

Requirements

1-2 Years of experience in HR Shared Services process and SLA management
Service management and ticket management system experience
Customer orientation
Process management and continuous improvement with a focus on optimization and productivity
Technical / Functional Skills & Knowledge of HR Tools and Interfaces
High level of accuracy and attention to details
Strong communication skills
Demonstrated track record of strong service delivery
Very good English language skills

Job Responsibility

Manage end-to-end medical services for employees, ensuring consistent and high-quality service delivery across the market
Oversee employee medical enrollment processes, including new hires, dependents, exits, terminations, and option changes
Manage relationships with medical vendors, ensuring service quality, SLA compliance, issue resolution, and budget adherence
Ensure timely review and submission of medical claims payments to payroll for inclusion in the monthly payroll cycle
Review, validate, and process medical insurance invoices in line with contractual terms and enrolled population data
Ensure streamlined and integrated medical services processes from technical, functional, and customer perspectives, supporting accurate decisions on eligibility, entitlements, and system integration
Monitor and report on service delivery performance against SLAs and KPIs, driving continuous improvement initiatives
Ensure accurate transaction tracking, data integrity, and consistent service delivery across all medical processes
Document and maintain updated medical processes and knowledge materials in alignment with relevant stakeholders
Conduct medical benefits orientations and open enrollment sessions

Lead Product Manager, Claims and Eligibility

Spring Health

Location:
United States , New York City

Category:
IT - Software Development

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 18, 2026

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