Principal Product Manager, Healthcare Payer Strategy

Oracle Oracle · Enterprise · United States

Product Manager for Oracle Health's healthcare payer strategy, focusing on defining roadmap, go-to-market, and influencing portfolio direction for payer solutions. The role emphasizes market dynamics and strategic opportunities, with a focus on modernizing and automating prior authorization workflows using AI-enabled solutions. Requires deep expertise in US healthcare payer operations and experience in product management or related roles.

What you'd actually do

  1. Define and help execute the product strategy and go-to-market vision for Oracle Health's healthcare payer solutions in the United States.
  2. Serve as a trusted advisor and product strategist for executive stakeholders at health plans, managed care organizations, government payers, and other healthcare organizations.
  3. Engage with prospective and existing customers to articulate Oracle Health's strategic vision and demonstrate the business value of our healthcare payer platform.
  4. Analyze healthcare market trends, competitive dynamics, regulatory developments, and emerging business models to identify strategic product opportunities.
  5. Influence product roadmap priorities across payer solution domains including claims adjudication, interoperability, analytics, contract management, benefit plan administration, provider reimbursement, and value-based care automation.

Skills

Required

  • Deep expertise in U.S. healthcare payer operations and business processes.
  • Strong understanding of healthcare claims adjudication, provider reimbursement, benefit administration, payer analytics, interoperability, and value-based care programs.
  • Strong understanding of healthcare utilization management, prior authorization workflows, and the operational interactions between authorization, claims adjudication, provider reimbursement, and medical management processes.
  • Experience working with healthcare payer operations related to utilization management, care management, prior authorization, claims administration, or provider operations.
  • Experience in product management, healthcare consulting, payer operations leadership, healthcare technology strategy, or a related role.
  • Demonstrated success developing product strategy, market strategy, or business transformation initiatives within healthcare payer organizations.
  • Strong executive communication, presentation, and stakeholder management skills.
  • Experience engaging with senior leaders and executive decision-makers within healthcare organizations.

Nice to have

  • Experience working with commercial health plans, Blues plans, Medicare Advantage organizations, Medicaid managed care organizations, or government healthcare programs.
  • Experience with prior authorization platforms, utilization management systems, care management solutions, or provider engagement technologies.
  • Knowledge of CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) and emerging industry standards supporting electronic prior authorization workflows.
  • Knowledge of healthcare interoperability standards and regulatory programs, including FHIR and CMS interoperability requirements.
  • Experience with healthcare analytics, population health, quality measurement, risk adjustment, payment integrity, and care management solutions.
  • Knowledge of value-based payment models and reimbursement methodologies, including ACOs, bundled payments, shared savings arrangements, and capitation.
  • Understanding of healthcare benefit configuration, contract modeling, network management, and provider reimbursement strategies.
  • Demonstrated expertise in leveraging generative AI and advanced AI technologies to support market analysis, strategic planning, customer engagement, product innovation, and decision-making.
  • Proven ability to identify opportunities for AI-enabled transformation across healthcare payer operations and technology platforms.
  • Experience supporting large-scale healthcare technology modernization or digital transformation initiatives.

What the JD emphasized

  • U.S. citizenship is required for this position
  • obtain and maintain a U.S. government security clearance after hire