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Product Owner (Utilization Management / Prior Authorization)

MindlanceBaltimore, MD

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Overview

Remote
On-site

Job Description

100% RemoteNote from HM: We re seeking a Business Integration Lead with strong Healthcare integration experience to drive complex, cross functional initiatives. This role leads program execution, aligns stakeholders, and ensures measurable improvements in PA performance, provider experience, and operational efficiency.Key Responsibilities Lead end to end delivery of PA (Prior Authorization) programs across clinical, technical, and operational teams Translate PA (Prior Authorization) strategy into actionable roadmaps and coordinated workstreams Partner with clinical leaders to optimize review workflows and regulatory complianceMonitor KPIs (TAT, auto decision rates, denials, provider friction) and lead continuous improvementQualifications 15+ years in healthcare delivery, payer operations, UM (Utilization Management), or PA (Prior Authorization) programs Proven experience leading large, multi workstream initiatives Strong understanding of PA workflows, UM criteria, and regulatory requirements Experience with PA technology, automation, and EHR/interop standards Excellent communication, stakeholder management, and executive level reporting skillsPURPOSE: Serves as an authority over Product Owners and product teams to ensure clarity in strategic direction. Brings an expertise to lead and manage project requirements and introduces new, beneficial tools and practices. Focuses on managing the development of products to meet the needs of internal and external clients, and helps to establish the business value for their development and implementation. Provides business point of view and guidance on opportunities and risks to support clients.ESSENTIAL FUNCTIONS: 20% Leads the development of the product portfolio and provides workable solutions to satisfy customer and market expectations in close collaboration with stakeholders, Product Owners, and scrum teams. 15% Collaborates with management to identify and plan product releases by reviewing milestones with stakeholders; manages the continual development of existing products. 15% Validates proposed solutions by performing market research to gain insights and inform; assists with pricing packages and structures. 10% Communicates internally and externally, develops and maintains Product Roadmap(s). 10% Manages Product Backlog(s) for the development teams by using product road mapping and backlog management tools. 10% Works closely with testing managers to ensure product functionality is properly tested against business requirements; leads change control processes to reflect project priorities. 5% Aides in the development process by attending product refinement, sprint planning, and sprint reviews. 5% Coordinates and organizes workshops with product users using the Client and define approach; validates hypotheses and implements best solutions. 5% Contributes to wider initiatives and activities that support and increase customer satisfaction. 5% Conducts product training to partners, staff, and identifies need for individual/team training opportunities.Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education Level: Bachelor's Degree Education Details: Product Management, Engineering, Information Technology or related field Experience: 8 years experience business analysis, business development, solutions development, system analysis, technical design/development implantation or equivalent experience OR 6 years Previous product owner experience with an in-depth knowledge of agile process and principles.In Lieu of Education In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.Preferred Qualifications Previous healthcare experience Advanced degreeKnowledge, Skills and Abilities (KSAs) Proficient in Agile methodologies, principles, and procedures., Expert Ability to use Product KPIs and business metrics to optimize the product., Expert Ability to recognize, analyze, and solve a variety of problems., Expert Ability to analyze, organize and prioritize work while meeting multiple deadlines., Expert The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.Licenses/CertificationsCertified Scrum Product Owner PO certification Upon Hire ReqEEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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FAQs About Product Owner (Utilization Management / Prior Authorization) Jobs at Mindlance

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This job at Mindlance is located in Baltimore, MD, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
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