产品经理-拒赔AI

Job Purpose The Associate Product Manager – Denials AI supports the development and execution of the Denials AI product by translating business needs, operational workflows, and data insights into clear product requirements and deliverables. The Associate Product Manager – Denials AI helps deliver features that improve denial classification, root-cause analysis, automation, and decision support across the denial and appeal lifecycle. The Associate Product Manager contributes insights that inform continuous product improvement and drive measurable impact aligned with Med-Metrix’s enterprise goals.
Duties & Responsibilities

• Support enhancements to denial classification and root-cause analysis across the denial and appeal lifecycle, helping translate clinical and administrative denial reasons into product requirements

• Assist with tracking and reporting on core Denials AI KPIs, including denial overturn rate, submission rate, denial-to-submission turnaround, and dollars recovered, across automated and manual-assisted workflows

• Support requirements for FHIR/HL7 data ingestion, EMR retrieval, and case creation on denial receipt, partnering with Data and Engineering to ensure claim, EOB, and coverage data are available for downstream models

• Support execution of the product vision and strategy by contributing insights, gathering inputs, and assisting in prioritization decisions aligned with Med-Metrix’s overall goals

• Support stakeholder communication through status updates, documentation, roadmap priorities, release impacts, and performance outcomes, ensuring clarity and alignment

• Support workflow standardization efforts while helping maintain configurable pathways to meet client, payer, and regulatory requirements

• Collaborate with client-facing and delivery teams to support workflow adoption, change management, and continuous improvement initiatives

• Assist in maintaining the product roadmap and tracking feature progress against defined goals

• Assist in defining and prioritizing product features under the guidance of Product Managers

• Translate product roadmap features into well-defined product requirements, including user stories, acceptance criteria, and supporting documentation

• Support Scrum activities, including backlog grooming, sprint planning, standups, and tracking sprint progress

• Identify and escalate risks and blockers impacting successful completion of release and sprint goals

• Support product demos, user acceptance testing (UAT), and feedback collection to inform product improvements

• Other duties as assigned

• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

• Understand and comply with Information Security and HIPAA policies and procedures at all times

• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

• Bachelor’s degree in a related discipline preferred

• 1–3 years of experience in product management, business analysis, healthcare technology, or a related field

• Familiarity with AI/ML-powered products or cloud-hosted platforms (e.g., AWS), including how models and data pipelines support product features

• Experience with payer–provider data exchange standards

• Foundational understanding of the product development lifecycle, with exposure to discovery, delivery, and iteration

• Experience with or familiarity with healthcare workflows; exposure to medical claim denials processes is a plus

• Experience supporting product delivery activities, including writing user stories, defining requirements, and working within Agile environments (e.g., Jira or similar tools)

• Understanding of iterative development practices, including prototyping, testing, and continuous improvement

• Familiarity with healthcare interoperability standards is a plus

• Strong analytical and problem-solving skills, with the ability to interpret data and support insight-driven decisions

• Demonstrated critical thinking skills, with the ability to break down problems and contribute to structured solutions

• Familiarity with EHR systems or integration workflows (Epic, Cerner, Meditech, etc.) is a plus

• Proficiency in Microsoft Office Suite

• Strong interpersonal skills, ability to communicate well at all levels of the organization

• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses

• High level of integrity and dependability with a strong sense of urgency and results oriented

• Excellent written and verbal communication skills required

Working Conditions

• Ability to work outside of normal business hours to support special projects

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear

• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress

• Work Environment: The noise level in the work environment is usually minimal

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Originally posted on Himalayas