合同建模产品负责人
Contract Modeling Product Owner
在Kodiak Solutions，我们致力于通过前沿的技术解决方案变革医疗行业。我们专注于医疗财务、无人认领财产、风险管理以及收入周期管理，帮助医疗组织优化复杂的财务流程。我们的使命是简化并优化流程，使医疗提供者能够专注于提供优质患者护理。
依托我们创新的平台，我们提供基于云的系统、自动化工作流和先进的数据管理工具，旨在解决医疗行业的独特挑战。无论是提高收入周期效率、处理无人认领财产问题，还是降低风险，我们的平台都能提供实时、可操作的洞察，以实现更好的结果。
合同建模产品经理负责领导下一代医疗合同建模平台的设计与开发，将复杂的支付方合同条款转化为可扩展的业务规则和产品功能。该职位是报销专家、产品领导和软件开发团队之间的关键联络人，推动需求收集、待办事项优先级排序、合同建模逻辑和产品交付。
主要职责可能包括以下内容。其他职责也可能被分配。
- 领导医疗合同建模平台路线图、需求和产品待办事项的定义与交付。
- • 将复杂的支付方合同语言转化为详细的业务规则、用户故事和技术规范。
- • 设计并验证报销建模逻辑，包括DRG、APC、每日费用、病例费率、免赔额、异常值和其他支付方法。
- • 与软件工程师、架构师、QA团队和外部开发合作伙伴合作，交付可扩展的产品功能。
- • 通过验证合同解读、建立审核流程和定义治理标准，支持基于AI的合同提取和自动化计划。
- • 收集客户和市场的需求，以增强未来功能，如欠付检测、合同合规性、情景建模、收入预测和战略定价。
资格要求：
- 在医疗报销、管理护理合同、收入周期或合同管理领域有5年以上经验。
- • 需要获得医疗管理、商业、金融或信息学相关专业的学士学位。
查看英文原文
At Kodiak Solutions, we’re dedicated to transforming the healthcare industry through cutting-edge, technology-driven solutions. We specialize in healthcare finance, unclaimed property, risk management, and revenue cycle management, helping healthcare organizations streamline complex financial operations. Our mission is to simplify and optimize processes, so healthcare providers can focus on delivering excellent patient care.
Powered by our innovative platform, we offer cloud-based systems, automated workflows, and advanced data management tools designed to address the unique challenges in healthcare. Whether it's improving revenue cycle efficiency, navigating unclaimed property issues, or mitigating risk, our platform delivers real-time, actionable insights to drive better outcomes.
The Contract Modeling Product Owner has the responsibility of leading the design and development of a next-generation healthcare contract modeling platform that transforms complex payer contract terms into scalable business rules and product functionality. This role serves as the key liaison between reimbursement subject matter experts, product leadership, and software development teams, driving requirements gathering, backlog prioritization, contract modeling logic, and product delivery.
Essential Duties and Responsibilities may include the following. Other duties may also be assigned.
- Lead the definition and delivery of a healthcare contract modeling platform roadmap, requirements, and product backlog.
- • Translate complex payer contract language into detailed business rules, user stories, and technical specifications.
- • Design and validate reimbursement modeling logic, including DRG, APC, per diem, case rate, stop-loss, outlier, and other payment methodologies.
- • Partner with software engineers, architects, QA teams, and external development partners to deliver scalable product functionality.
- • Support AI-powered contract extraction and automation initiatives by validating contract interpretation, establishing review processes, and defining governance standards.
- • Gather customer and market requirements to enhance future capabilities such as underpayment detection, contract compliance, scenario modeling, revenue forecasting, and strategic pricing.
Qualifications:
- 5+ years of experience in healthcare reimbursement, managed care contracting, revenue cycle, or contract management.
- • Bachelor's degree required in Healthcare Administration, Business, Finance, Information Systems, or a related field.
- • Expertise interpreting commercial payer contracts and reimbursement models, including DRG, APC, per diem, and case-rate methodologies.
- • Experience gathering business requirements and partnering with software development teams to deliver technology solutions.
- • Strong knowledge of healthcare financial data, claims adjudication, and reimbursement analytics.
- • Preferred experience with product ownership, contract modeling platforms, Agile development, and AI-driven document automation.
- • Candidates must be legally authorized to work in the United States. This position is not eligible for employment visa sponsorship now or in the future.
Originally posted on Himalayas