Lead Product Owner

Job Summary

To stabilize and enhance end-to-end Prior Authorization operations, the contract Lead Product Owner will work remotely, focusing on identifying failure points and driving improvements in accuracy, turnaround time, and provider experience across clinical, IT, claims, and operations teams.

Key responsibilities

• Own end-to-end Prior Authorization program delivery, collaborating with clinical, technical, and operational teams
• Lead requirements work by gathering, documenting, and translating functional/non-functional requirements into user stories and acceptance criteria
• Track and improve PA performance metrics, addressing breakdowns in the PA/claims process and implementing necessary fixes

Required qualifications

• Bachelor's degree in Business Administration, Management, Finance, or a related field, or equivalent experience
• 15+ years in payer operations, healthcare delivery, or utilization management with deep expertise in Prior Authorization
• 8-10+ years of experience as a Product Owner or equivalent in a healthcare environment
• Proven ability to lead large, cross-functional initiatives and drive outcomes to closure
• Strong knowledge of FACETS, GuidingCare, and EDI 278, particularly in relation to PA and claims processes