Product Manager, Claims and Enrollment Job at Stedi

Technical Product Manager III

The Technical Product Manager (TPM) III serves as a strategic bridge between bus...

Location

United States , Los Angeles

Salary:

207808.00 - 353272.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Computer Science or Related Field
At least 10 years of experience in a health plan, payer organization and/or health system, ideally as a Technical Product Management or similar role
Experience in at least one of the following healthcare domains: Customer Engagement / Front Office Operations: enrollment and eligibility, call center, member/provider portals, member outreach, appeals and grievances, sales/marketing portals
Health Services Delivery and Quality Oversight: care management, population health, behavioral health, pharmacy, UM authorizations, quality oversight
Provider Network Operations / Data: provider portals, provider data management & network operations enablement, Prior Authorization Interoperability (PAI) submission workflows
Finance / Claims / HR / Compliance Enablement: claims processing & payments, payment integrity, encounter processing, billing/reporting, HR/compliance systems
Proven experience translating complex business needs into clear problem statements that enable technically ready requirements for IT and development teams
Experience delivering enterprise digital solutions that improve member and provider experience, operational efficiency, and maintain regulatory compliance
Experience with agile product management frameworks, backlog prioritization, sprint planning and related tools, including prior exposure to health plans or health system digital solutions
Experience collaborating with cross-functional business and IT teams to drive enterprise solution delivery and ensure alignment with organizational priorities

Job Responsibility

Leads business stakeholders in defining product vision, solution intent, scope, value hypothesis, and roadmap aligned with enterprise strategy and measurable business outcomes
ensures enterprise-wide impact and alignment across multiple business verticals and strategic objectives, while owning one or more domains and coordinating cross-domain roadmaps in collaboration with other TPMs
Drives the translation of complex business needs into clear problem statements and outcomes that inform technically ready requirements for IT and development teams
Ensures requirements are accurate, complete, timely, and aligned with defined success metrics to support product strategy and enterprise delivery of business value
Partners with internal teams ensure business requirements and product intent are clearly understood and proposed solutions align with enterprise reference architecture and governance standards
Provides guidance and oversight to ensure requirements are technically ready and aligned with product strategy and evaluates integration dependencies and trade-offs across systems
Collaborates with key stakeholders to ensure the product backlog for the domain is effectively prioritized, supports other TPMs with cross-domain backlog coordination, and participates in sprint planning and review sessions to maintain strategic alignment
Manages the delivery of quality and member-focused digital solutions
Ensures the business units understand the technology solution, overall solution delivery, and compliance with governance processes, architecture standards, as well as their roles and accountabilities in each phase of the delivery cycle
Provides oversight for testing, validation, and deployment activities to ensure solutions align with business intent, success metrics, and regulatory requirements, while advising teams on enterprise-level expectations

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

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

Hc & Insurance Operations Senior Assoc

At NTT DATA, we know that with the right people on board, anything is possible. ...

Location

India , Chennai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

3+ years of experience in US healthcare working with Provider Data Management
Ability to work regularly scheduled shifts from Monday-Friday 20:30pm to 5:30am IST
University degree or equivalent that required 3+ years of formal studies
Ability to work in a team environment
Good logical thinking ability
Good English Comprehension/written skills should have exposure to MS Office
Good Communication Skills – Both Verbal and Written
Ability to interact with clients preferred
Own Transport

Job Responsibility

Process and review Provider Data Management and Provider Data Enrollment Resources to the Client main application
Train the team on new process and process updates
Calibrate with QA’s to ensure process knowledge and variance are managed
Create Process SOP, Process Map and identify outliers
Review Discrepancy report and comments, identify gaps and share with TL
Identify NVA and provide suggestion for automation opportunities
Lead teams to manage day to day inventory
Monitor QA scores of production resources and perform reviews
Floor support to operations and 1st point of escalation
Identify refresher/re-trainable topics, conduct assessments, and certify staff

Fulltime

Business Intelligence Analyst - Hybrid

As a vital member of the Business Intelligence team, the Business Intelligence A...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

3 years of experience in operations with knowledge of enrollment and/or claim systems (All Levels)
3 years of experience in a professional business environment (including internships) (All Levels)
High-School Diploma or GED in general field of study (All Levels)

Job Responsibility

Analyze and research complex operational problems related to quality control and procedures in assigned unit
Develop and maintain test plans with Enrollment and Claim areas for UAT
Perform UAT as needed and assigned
Provide project management support alongside the Product Owner as needed
Assist in Requirement gathering meetings and document requirements in a learning capacity
Create and/or update training material for the end-users
Investigate data issues found through UAT or analysis of reporting
With supervision, analyzes data output and recommends changes and enhancements to existing reporting, business procedures and business rules
Create ad-hoc reporting through various systems in a learning capacity
Act a liaison between management, staff, and vendors

Fulltime

Pharmacy Intern

Learn to provide the best patient experience through assisting the pharmacist an...

Location

United States , Spokane

Salary:

18.00 - 31.00 USD / Hour

Walgreens

Expiration Date

Until further notice

Requirements

Must be enrolled in a school of Pharmacy program
Must be fluent in reading, writing, and speaking English
Requires willingness to work flexible schedule, including evening and weekend hours.

Job Responsibility

Learn to provide the best patient experience through assisting the pharmacist and pharmacy team members in accordance with state and federal regulations
Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions
Models and delivers a distinctive and delightful customer experience
Learns and champions pharmacy policy, procedures, and customer service best practices needed to perform as a future pharmacist
Engages customers and patients by greeting them and offering assistance with products and services
Resolves customer issues and answers questions to ensure a positive customer experience
Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits and Walgreens service traits
Develops strong relationships with customers
Learn from store and pharmacy team members, field leadership, team members and customers/patients
Under the supervision by the pharmacist, assist in the practice of pharmacy, in accordance with state, federal, and company policy

Part-time payroll & hr consultant

Location

United States , Lakeville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

5+ years of experience in human resources, payroll, or a closely related HR support role
Hands-on experience processing payroll in an automated environment with a strong focus on accuracy and confidentiality
Working knowledge of benefits administration, including employee enrollments, updates, and general plan support
Familiarity with HRIS platforms and employee self-service tools used for HR and payroll administration
Ability to review timekeeping information carefully and resolve discrepancies in a timely manner
Strong communication skills with the ability to respond clearly to employee questions and provide practical guidance
Experience supporting onboarding or broader HR administrative processes is preferred
Highly organized with the ability to manage recurring deadlines and routine weekly and biweekly tasks effectively

Job Responsibility

Process biweekly payroll
401(k) & HSA funding (biweekly, Monday following payroll)
Review timecards for accuracy (weekly on Mondays)
DVM production calculations (1–2 hours, once per month)
Respond to employee inquiries, including workers’ compensation claim guidance, eSELFSERVE troubleshooting
Assist with benefits administration (enrollments, changes, questions)
Support onboarding and offboarding (background checks, new hire paperwork, separations)

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan

Parttime

Account Manager

We are looking for an Account Manager to join our insurance team in Greenville, ...

Location

United States , Greenville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in account management, client services, or a similar customer-facing business role
Background supporting B2B relationships with a strong focus on responsiveness and service quality
Ability to build credibility with clients and maintain productive client partnerships
Strong organizational skills with experience handling detailed records and multiple account updates accurately
Effective communication skills, with the ability to collaborate across departments and resolve client concerns
Comfort managing inbound requests and prioritizing tasks in a fast-paced environment
Familiarity with inside sales or consultative client support is preferred
Insurance industry experience or the ability to quickly learn industry products and services is highly valued

Job Responsibility

Cultivate and maintain strong relationships with business clients to support retention, satisfaction, and long-term partnership growth
Keep account information current by tracking client activity, including hours reporting, enrollments, onboarding updates, and terminations
Respond to client questions and concerns promptly, ensuring issues are addressed thoroughly and professionally
Partner with customer service and claims teams to coordinate solutions and provide a seamless experience for clients
Develop in-depth knowledge of insurance products and service offerings in order to guide clients with accurate and relevant information
Manage inbound inquiries and follow up consistently to support account needs and identify additional service opportunities
Monitor account trends and client interactions to help improve service delivery and strengthen overall account performance

What we offer

medical, vision, dental, and life and disability insurance
company 401(k) plan

Hc And Insurance Operations Senior Assoc.

At NTT DATA, we know that with the right people on board, anything is possible. ...

Location

India , Chennai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

3+ years of experience in US healthcare working with Provider Data Management
Ability to work regularly scheduled shifts from Monday-Friday 20:30pm to 5:30am IST
University degree or equivalent that required 3+ years of formal studies
Ability to work in a team environment
Good logical thinking ability
Good English Comprehension/written skills should have exposure to MS Office
Good Communication Skills – Both Verbal and Written
Ability to interact with clients preferred
Own Transport

Job Responsibility

Process and review Provider Data Management and Provider Data Enrollment Resources to the Client main application according to its policies and procedures defined
In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management
Ability to train the team on new process and process updates
Calibrate with QA’s to ensure process knowledge and variance are managed and under control
Ability to create Process SOP, Process Map and identifying the outlier within process
Review Discrepancy report and comments, identify gaps and share with TL
Identify NVA and provide suggestion for automation opportunities
Leads teams to manage day to day inventory
Monitors QA scores of production resources and performs reviews to improve overall performance
Floor support to operations and 1st point of level of escalation to client in process, inventory, and performance metrics

Fulltime

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Product Manager, Claims and Enrollment

Job Description

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