Product Manager, Claims and Enrollment Job at Stedi

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

Senior Trainer – Business Training (Payer Services)

We are looking for a dedicated and experienced Senior Trainer to join our team, ...

Location

India , Chennai

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Minimum 6 years of work experience
Strong understanding of compliance requirements and payer services processes
Exceptional communication and presentation skills
Ability to conduct engaging and effective training sessions
Strong organizational skills and attention to detail
Ability to work collaboratively with different teams and stakeholders
A proactive approach to problem-solving and process improvement
In-depth knowledge of the Revenue Cycle Management (RCM)
Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization
Expertise on Payer terminologies (Related to Medicare Advantage programs ) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation.

Job Responsibility

Develop comprehensive training materials covering the general concepts of Payer Services with a focus on preprocess training
Manage the onboarding process, including system collection, OIG, whitelisting URLs, and ARC orientation training
Conduct client specific orientation sessions to ensure new hires are fully integrated into the company culture and processes
Deliver compliance courses for all employees to ensure adherence to regulatory requirements
Prepare training content for Maintenance of Certification (MOC) and train client partners, ensuring successful assessment closure
Provide client-specific process training for new hires, ensuring they understand all relevant procedures and policies
Offer on-the-job training (OJT) support to new hires, facilitating their transition into their roles
Develop and conduct weekly training sessions based on new updates and error trends
Conduct weekly refresher courses, coaching, and feedback sessions to maintain high performance levels
Maintain extensive knowledge of all processes and sub-processes within Payer Services

Associate Medical Stop Loss Underwriter

This job prices quotes and analyzes the structure of a contract for a group base...

Location

United States , Working at Home - Pennsylvania

Salary:

23.16 - 35.88 USD / Hour

Highmark Health Options

Expiration Date

Until further notice

Requirements

Bachelor's Degree - Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline
0 - 2 years of experience in Insurance, Underwriting of Self-Funded and/or fully insured prospects preferred
Developing understanding and knowledge of various internal departments and external stakeholder interacts
Ability to use applicable computer systems, electronic tools and applications
Ability to work independently and assume responsibility for routine projects
Demonstrate an understanding and support of corporate and departmental goals and initiatives
Demonstrate ethical business practices with adherence to all privacy and confidentiality policies and regulations
Good problem-solving, organizational, and negotiation skills required
Excellent math aptitude required to complete analysis

Job Responsibility

Prices quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc.
Develops and uses discretion of Underwriting authority, within the policies of HMIG, and ensure appropriate levels of profitability and growth over time
Identifying when to decline quotes that do not fit into the overall HMIG strategy and risk structure
Analyzes risk factors for new enrollment, annual renewals, and amendments of group insurance contracts or of self-funded plans in conformance with established underwriting policies, practices, and standards
Analyzes associated policies, guidelines, market data to continuously improve risk management and gain appropriate enrollment or manage existing membership
Analyzes data such as financial conditions of the organization, participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered and to set the rates
Prepares a variety of reports and provides rationale and support to other areas within the organization, clients, and possibly producers regarding one or more of the following: underwriting results, rate computations and financial activity
Provides expense estimates and accurate analysis of financial exhibits
Responsible for a book of business of renewing accounts and writing new business at profitable levels to help HMIG achieve overall business targets/ or assigned volume of new applications or RFP’s
Utilizes various systems and tools to obtain necessary data and accurately complete and track assigned work

Fulltime

New

Enterprise Quality Program Test Lead

The Alabama Medicaid Agency (AMA) has embarked on a major transition from a mono...

Location

United States , Montgomery

Salary:

Not provided

Dash Technologies

Expiration Date

Until further notice

Requirements

2 - 3 years of experience in using AI tools for EE2E Testing, API testing using open-source automation tools and testing Snowflake cloud data platform
2 - 5 years of experience in testing MMIS system
2 - 5 years of experience in preparing and executing an EE2E Test Strategy and creating data for EE2E testing
3 - 5 years of experience in preparing and executing ETL test cases
3 - 5 years of experience in member and provider enrollment and management, claims adjudication, and processing payments
3 - 5 years developing test strategies for complex business applications and systems
3 - 5 years of experience with large multi-vendor projects or teams
3 - 5 years of experience working with management and key stakeholders
5 - 7 years of report testing, creating UAT test cases, conducting and executing UAT
5 – 7 years quality assurance and test management experience

Job Responsibility

Serves as the UAT Test Lead and drives UAT for Medicaid applications, ensuring systems for claims, eligibility, and providers meet business requirements, and CMS regulations
Leads UAT execution, manage testers, coordinate with stakeholders, and oversee defect resolution to ensure a high-quality compliant system
Serve as the EE2E Test Lead and drive EE2E testing for Medicaid applications, validating the entire Medicaid Management Information System (MMIS) workflow from claim submission to payment ensuring all components, databases, and third-party interfaces function together under real-world scenarios
Identify the EE2E scenarios, prepare EE2E test cases, work with vendors to conduct the enterprise EE2E testing
Act as a trusted partner with contractors and Agency managers to ensure testing outcomes reach program goals and key initiatives achieve desired results
Develop, design, and oversee metrics and Key Performance Indicators (KPIs) that provide insight to the health of the quality assurance program
Perform Test Analyst activities with experience in developing, implementing and evaluating a multi-phase Enterprise Test Strategy
Experience developing software tests for functional performance, UAT and Enterprise EE2E testing that include automated, ad-hoc, and manual testing elements
Strong knowledge of MMIS EE2E testing
Strong knowledge of identifying the business processes in MMIS system

Fulltime

DC HR & Office Business Partner

Provide human resources support for DC management and team members including rec...

Location

United States , Billings

Salary:

Not provided

O'Reilly Auto Parts

Expiration Date

Until further notice

Requirements

High school diploma or equivalent (GED)
2+ years previous experience as a Human Resources Specialist
Proficient in PC programs, ten-key, data entry, and mid-range computer systems
Strong interpersonal, written and verbal communication skills
Excellent communication, leadership, and employee relations skills specifically in recruiting and counseling
Must be able to multitask and work well in a team environment
Experience with PCs

Job Responsibility

Provide human resources support for DC management and team members including recruiting and hiring applicants, conducting new team member orientation, and benefits classes
Maintain close contact with corporate human resources to ensure compliance with O’Reilly policies and procedures, and state/federal employment laws and regulations
Provide team member relations support, and work with management and team members to ensure the highest level of morale and productivity
Responsible for the recruitment of distribution center positions which includes attending local job fairs, establishing a relationship with local schools and temporary agencies to recruit for openings, and drafting and placing employment advertisements
Accept Referral Bonus Forms and forward to Corporate Human Resources
Maintain current job requisitions and prepare and post internal and corporate job opening announcements
Coordinate the application process and conduct preliminary interviews, pre-employment testing, check references, and arrange pre-employment drug screens
Support the DC Manager and supervisors in team member relations efforts
work to ensure high team member morale, and coordinate the progressive discipline process and application of other human resources policies with local management and corporate
Conduct new team member orientation, ensure timely completion of new hire paperwork, and benefit enrollment information

What we offer

Competitive Wages & Paid Time Off
Stock Purchase Plan & 401k with Employer Contributions Starting Day One
Medical, Dental, & Vision Insurance with Optional Flexible Spending Account (FSA)
Team Member Health/Wellbeing Programs
Tuition Educational Assistance Programs
Opportunities for Career Growth

Fulltime

Marketing Specialist

The Marketing Specialist will be part of the Institutional Marketing team that o...

Location

United States , Columbia

Salary:

49199.33 - 88841.36 USD / Year

Adtalem Global Education

Expiration Date

Until further notice

Requirements

Bachelor’s degree required
Three (3) plus years’ experience in marketing or advertising agency preferred
Strong project management and communication skills
Knowledge of offline and digital media
Innovative thinker, collaborative team player and skilled communicator
Ability to convey complex subjects to stakeholders in an understandable way
Expert knowledge of Microsoft Suite (Word, Excel, PPT)
Ability to work independently at a fast pace
Accuracy and accountability for work
Must be well organized and detail oriented

Job Responsibility

Develop annual marketing plan based on business goals (at university and program level) that align within the overall brand
Working closely with enrollment and media channel managers to develop marketing strategies, positioning and tactical execution
Determine how to improve awareness, lead flow and conversion
Collaborate with internal teams and agency partners on the development and optimization of media plans that will increase traffic, leads/inquiries, new students and revenue
Work with analytics team to use data-driven insights and analytics to track performance against initiative goals and inform strategic decision making
Work with internal teams responsible for day-to-day execution of projects across Adtalem’s online and offline media activities, ensuring timely coordination between brand, creative and operations
Compile and update product claims, key benefits, and differentiators
Manage execution of creativity in market with agencies including ensuring that creatives match brand guidelines and pass legal and regulatory approval
Create personalized content for each point along customer journey
Develop ongoing webinar content and coordinate execution with enrollment, faculty and events team

What we offer

Health, dental, vision, life and disability insurance
401k Retirement Program + 6% employer match
Participation in Adtalem’s Flexible Time Off (FTO) Policy
12 Paid Holidays

Fulltime

Marketing Specialist

The Marketing Specialist will be part of the Institutional Marketing team that o...

Location

United States , Chicago

Salary:

49199.33 - 88841.36 USD / Year

Adtalem Global Education

Expiration Date

Until further notice

Requirements

Bachelor’s degree required
Three (3) plus years’ experience in marketing or advertising agency preferred
Strong project management and communication skills
Knowledge of offline and digital media
Innovative thinker, collaborative team player and skilled communicator
Ability to convey complex subjects to stakeholders in an understandable way
Expert knowledge of Microsoft Suite (Word, Excel, PPT)
Ability to work independently at a fast pace
Accuracy and accountability for work
Must be well organized and detail oriented

Job Responsibility

Develop annual marketing plan based on business goals (at university and program level) that align within the overall brand
Working closely with enrollment and media channel managers to develop marketing strategies, positioning and tactical execution
Determine how to improve awareness, lead flow and conversion
Collaborate with internal teams and agency partners on the development and optimization of media plans that will increase traffic, leads/inquiries, new students and revenue
Work with analytics team to use data-driven insights and analytics to track performance against initiative goals and inform strategic decision making
Work with internal teams responsible for day-to-day execution of projects across Adtalem’s online and offline media activities, ensuring timely coordination between brand, creative and operations
Compile and update product claims, key benefits, and differentiators
Manage execution of creativity in market with agencies including ensuring that creatives match brand guidelines and pass legal and regulatory approval
Create personalized content for each point along customer journey
Develop ongoing webinar content and coordinate execution with enrollment, faculty and events team

What we offer

Health, dental, vision, life and disability insurance
401k Retirement Program + 6% employer match
Participation in Adtalem’s Flexible Time Off (FTO) Policy
12 Paid Holidays

Fulltime

Sr. Manager, APM Modeling & Analytics

Arcadia is expanding its leadership in advanced alternative payment models (APMs...

Location

United States

Salary:

Not provided

The Muse

Expiration Date

Until further notice

Requirements

Bachelor's Degree in related Data Science, Actuarial Science, Finance, Economics or related field
Minimum of 6 years of healthcare experience, with a focus on CMS APMs, value-based contracting and analytics
Strong accountability, intellectual curiosity, and customer satisfaction mindset
Experience modeling and evaluating key financial parameters within value-based contracts for health plan or provider
Experience with database querying (SAS, SQL, Python), Amazon Quick Site or BI Tool equivalent

Job Responsibility

Own end-to-end financial modeling for CMS LEAD and other APMs
Translate CMS technical specifications into production-grade actuarial models
Develop and maintain benchmark, attribution, risk adjustment, and reconciliation logic
Ensure integrity of actuarial inputs (e.g., underwriting methodology, pricing assumptions) in value-based contract modeling
Identify model vulnerabilities and proactively mitigate financial exposure
Work directly with CMS VRDC data environments to extract, structure, and analyze Medicare claims and enrollment data
Write production-level SAS and Python code to process large claims datasets, facilitate risk-adjustments, calculate, risk adjust, and project PMPM benchmarks, run sensitivity testing, conduct reconciliation and true-up calculations
Ensure compliance with CMS methodological guidance
Validate data integrity prior to model production
Establish independent validation standards and ensure consistent adherence to these standards across the enterprise

What we offer

Pet Insurance
Health Insurance
Dental Insurance
Vision Insurance
FSA
HSA
HSA With Employer Contribution
Life Insurance
Short-Term Disability
Long-Term Disability

Product Manager, Claims and Enrollment

Stedi

Location:
United States

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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