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Availity

Product Manager, Authorizations (Remote)

RemoteUnited States only
Published
Role
Product
Experience
Senior
Employment
Full-time
Company size
Enterprise
Salary not disclosedModel estimate · $140k–$180k/yrMedium confidence · 80 comparable rolesMedian $165k · Based on role, seniority, location, requirements, company profile, industry, employment type, and work arrangement
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No BS summary

Product Manager with 5+ years' product management experience in healthcare technology, deep expertise in prior authorization workflows, and strong technical knowledge of X12 278 and FHIR prior authorization transactions. Must be eligible to work in the United States (no sponsorship). Remote within the United States; CMS/regulatory compliance experience required.

Core skills

prior authorization workflowsFHIR (CRD/DTR/PAS)

Required skills

X12 278FHIRFHIR CRDFHIR DTRFHIR PASEHR systemsutilization management platformsAPI specificationsrequirements gathering

Optional skills

AI-driven utilization management solutionsautomation technologiesknowledge of full revenue cycle

Required languages

English

What you'll do

  • Define and communicate a clear product roadmap aligned with CMS requirements, industry trends, and organizational goals.
  • Gather and document business requirements through stakeholder interviews and workflow analysis.
  • Translate requirements into user stories, acceptance criteria, and API specifications for engineering teams.
  • Validate interoperability standards (X12 278, FHIR CRD/DTR/PAS) for transactions between EHRs, Availity, and payer/vendor systems.
  • Collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases.
  • Serve as the subject matter expert on prior authorization workflows and FHIR standards; provide guidance internally and externally.
  • Monitor CMS mandates, industry trends, and client feedback to inform product decisions and prioritize features.
  • Lead pilots, define KPIs/OKRs, and drive successful go-to-market strategies.
  • Define product performance metrics and partner with data teams to deliver actionable insights for ROI and gainshare.
  • Align executives, clients, and internal teams on product vision, progress, and outcomes.

What they require

  • Minimum of 5 years’ experience in Product Management preferably with client facing experience within healthcare technology.
  • Deep expertise in prior authorizations workflows. This is required to be considered for the role.
  • Strong technical background with an understanding of the CMS 0057-F requirements for prior authorization and the X12 278 EDI and FHIR prior authorization (CRD, DTR, and PAS) transactions.
  • Knowledge of EHR systems and utilization management platforms and vendors.
  • Technical acumen, the ability to gather and describe market requirements and get feedback from technical staff and customers.
  • Business acumen: ability to contribute to a business case, evaluate feasibility & scalability, and driving ROI.
  • Familiarity with regulatory requirements and compliance standards.
  • Proven ability to lead cross-functional initiatives and influence stakeholders.
  • Video camera usage required for virtual meetings (camera-first culture).
  • Sponsorship, in any form, is not available for this position.
  • Candidates required to pass a drug test before beginning employment.
  • Federal law requires verification of identity and employment eligibility; Availity uses I-9 and may use E-Verify.

Benefits

  • Competitive salary
  • Bonus structure
  • Generous HSA company contribution
  • Healthcare, vision, dental benefits
  • 401k match program (available day one)
  • Unlimited PTO for salaried associates + 9 paid holidays
  • Hourly associates PTO starting at 19 days
  • Up to $250/year reimbursement for wellness (gym, races, weight management)
  • Education reimbursement
  • Paid Parental Leave for birth and adoptive parents
  • Volunteer/community engagement programs

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations.

🇺🇸 United StatesHealthcareEnterprise

Details

Visa sponsorshipNo
Salary not disclosed