Senior Product Manager, Eligibility & Coverage

Description

The role sets strategy and the roadmap for the products hospitals and health systems use to check a patient's insurance eligibility, find coverage the patient has not disclosed, and see the full picture of their benefits.

You will lead an engineering team of about 3 to 8 engineers and act as a main contact for health-system customers on eligibility and coverage questions.

Responsibilities

• Take ownership of eligibility verification, coverage discovery, benefits summaries and explanations, and payer connections and data sources that help hospitals and health systems see a patient's whole insurance situation.
• Research the market and analyse data to find customer needs and trends, then build the long-term roadmap and business cases for high-impact work such as adding payers or new data sources.
• Track product and payer response performance with analytics, including AI-assisted analysis, to spot incomplete, unclear or incorrect eligibility responses and confirm which data sources most improve coverage discovery accuracy.
• Lead a team of about 3 to 8 engineers building eligibility and coverage discovery products, and make the delivery and quality calls.
• Work closely with engineering and design leads to settle hard trade-offs when connecting new payers and eligibility data sources.
• Use agentic AI and tools built into development environments, such as Cursor and Cowork, to speed up discovery, requirements and prototypes, and find responsible ways to build AI into the product.
• Run customer meetings, present the roadmap, collect feedback and negotiate competing requests so they fit the wider product strategy.
• Manage relationships across engineering, compliance and payer operations, with health-system customers and payer partners, applying healthcare rules such as HIPAA, X12 EDI standards and CMS interoperability requirements to manage compliance and risk.

Requirements

• At least 5 years of product management experience, including owning a product area from start to finish.
• Experience in healthcare IT, revenue cycle management (RCM), or health insurance or payer operations. Direct work with patient eligibility verification (270/271 EDI transactions) or coverage discovery is strongly preferred.
• Experience leading an engineering team of about 3 to 8 engineers without close supervision and owning a product roadmap.
• Experience using data analysis, including AI-assisted analysis, to test assumptions and set product priorities.
• Experience running customer meetings, presenting roadmaps and negotiating scope with outside stakeholders.
• Hands-on use of AI tools, including chat assistants, agentic tools, and development or prototyping tools.
• Knowledge of healthcare regulation and data protection rules, such as HIPAA and EDI standards.
• Live in or near one of the designated Collaboration Hubs for this role.

Conditions

You will report to the Sr. Director of Eligibility & Coverage. The company hires for its hub locations and expects people there to work in person with colleagues, which supports collaboration, team connections and long-term career growth. You must live in or near one of these hubs: Costa Mesa, CA; San Jose, CA; Allen, TX; Austin, TX; Franklin, TN; New York, NY; Schaumberg, IL; Washington, D.C.; Atlanta, GA; Boston, MA; or Seattle, WA.

The work model is hybrid.

The base pay range is shown in the posting. Pay within that range depends on work location and factors such as job-related skills, experience and education. The role is also eligible for variable pay.

The company is an equal opportunity employer for all groups protected by federal, state and local law, including protected veterans and people with disabilities. Ask for accommodation as early as possible if you need one.

Benefits

• A compensation package and bonus plan.
• Core benefits, including medical, dental and vision, plus a 401(k) with matching.
• Flexible time off, including volunteer time, vacation, sick leave and 12 paid holidays.
• Flexible work arrangements: remote, hybrid or in office.