Sr. Director, Product Management and Strategy

Job Title: Sr. Director, Product Management and Strategy - Self-Directed Care & Financial Management Services (FMS)

Location: [Location/Remote]

Job Type: [Full-Time]

About Us:
 PPLFirst is dedicated to revolutionizing how individuals manage their care through innovative Self-Directed Care and Financial Management Services (FMS). We empower consumers to have greater control over their care and financial decisions while maintaining compliance, efficiency, and transparency. Our mission is to create solutions that meet the evolving needs of consumers, caregivers, and stakeholders in the healthcare ecosystem.

Job Overview:
 We are looking for an experienced and strategic Sr. Director, Product Management and Strategy to lead product strategy, design, and execution for our Self-Directed Care & Financial Management Services (FMS) products. This leadership role will be key in building and mentoring a strong bench of Product Analysts and Product Managers, collaborating with cross-functional teams (operations, client engagement, engineering, and legal), leading competitive analysis, and leveraging data-driven insights to create new product capabilities. The ideal candidate will have a deep understanding of the self-directed care ecosystem, including strategies to combat fraud, abuse, and waste, and will be an advocate for our consumers, ensuring that products meet their needs while delivering superior operational efficiency and business results.

Key Responsibilities:

• Product Strategy & Vision:
  • Lead the development of the product vision, strategy, and roadmap for Self-Directed Care and Financial Management Services (FMS) products, ensuring they align with company goals and consumer needs.
  • Define product goals, features, and success metrics with an emphasis on driving client success and operational excellence.
  • Lead competitive analysis efforts to identify market trends, customer demands, and potential areas for differentiation. Translate insights into actionable product capabilities that help position the company ahead of its competitors.
• Building a High-Performing Product Team:
  • Build, mentor, and lead a high-performing team of Product Analysts and Product Managers to front-end work with operations, client engagement, and external stakeholders.
  • Guide your team in understanding market requirements, formulating strategic roadmaps, and developing data-driven insights to influence product decisions.
  • Foster a culture of collaboration and innovation within the product team, ensuring that they deliver high-quality, user-centric solutions to improve client outcomes and internal operations.
• Fraud, Abuse, and Waste Prevention:
  • Leverage data-driven insights to identify potential fraud, abuse, and waste within the self-directed care and financial management services systems.
  • Collaborate with data teams to implement detection algorithms, patterns, and anomalies that could signal fraudulent activities, inefficiencies, or improper use of resources.
  • Design product features and capabilities that allow for monitoring, flagging, and reducing fraud, waste, and abuse while ensuring compliance and protecting consumer interests.
  • Work with legal, regulatory, and compliance teams to ensure all fraud prevention measures meet federal and state regulations.
• Competitive Analysis & Market Research:
  • Lead competitive analysis and market research to evaluate competitor offerings, understand emerging trends, and identify gaps and opportunities in the market.
  • Propose new product features and capabilities based on competitive insights, ensuring that products remain innovative and aligned with customer needs.
  • Incorporate market intelligence into product planning, ensuring that the roadmap is data-driven and focused on delivering maximum value to consumers.
• Cross-Functional Collaboration:
  • Work closely with operations, client engagement, engineering, and legal teams to ensure successful product development and execution.
  • Collaborate with external stakeholders, including government agencies, care managers, and fiscal intermediaries, to ensure alignment of product goals with regulatory requirements and customer expectations.
  • Communicate product roadmaps and progress to both internal teams and external stakeholders, ensuring transparency and alignment at all levels.
• Product Lifecycle & Development:
  • Oversee the full product lifecycle, from ideation through launch, and manage continuous improvement based on user feedback and performance metrics.
  • Define, track, and analyze OKRs (Objectives and Key Results) to measure the success of product initiatives and ensure alignment with broader company goals.
  • Ensure that products and features meet the regulatory requirements of the self-directed care space, including EVV compliance, gross-to-net payroll calculations, and service billing.
• Prioritization & Execution:
  • Lead the prioritization of change requests from operations, client engagement, and billing teams, ensuring that critical updates and enhancements are addressed first.
  • Ensure that new product capabilities and changes are executed effectively and efficiently, minimizing disruption to internal teams and consumers.
• Product Design & User Experience:
  • Work with design and engineering teams to create intuitive, user-friendly product interfaces and workflows that align with the needs of consumers and caregivers.
  • Ensure that products are optimized for usability and meet the needs of both consumers and stakeholders while adhering to industry standards.
• Client Success & Operational Excellence:
  • Collaborate with client engagement and operations teams to ensure that products improve the experience for consumers, caregivers, and other stakeholders in self-directed care programs.
  • Drive continuous improvement to both product features and internal processes to ensure that clients and internal operations benefit from a seamless experience.

Domains of Responsibility:

• Data Exchange: Oversee data flows related to auths, enrollments, and other exchanges between healthcare providers, payers, and government entities.
• Leads & Referrals: Manage systems for handling leads, referrals, and tracking progress through the self-directed care journey.
• Enrollments: Ensure seamless enrollment processes for consumers in self-directed care programs.
• Time Sheet Rules: Define and improve time sheet rules to ensure timely payments for care providers.
• Service Codes & Billing: Manage service codes and ensure accurate service billing and claim denials processes.
• Authorization Intake & Adjudication: Oversee the authorization intake and time sheet adjudication processes.
• Payroll Calculation: Lead the development of gross-to-net payroll calculation systems.
• EVV Compliance: Ensure compliance with EVV requirements for tracking care provider visits and services delivered.

Qualifications:

• Bachelor’s degree in Business, Healthcare Administration, Computer Science, or related field (Master’s preferred).
• 10+ years of experience in Product Management, with at least 5 years in a leadership role, preferably in healthcare, self-directed care, or related services.
• Proven experience in building and leading high-performing teams of Product Analysts and Product Managers.
• Strong background in conducting competitive analysis and translating insights into actionable product strategies.
• Expertise in data-driven insights, particularly in detecting and preventing fraud, abuse, and waste in financial and care services.
• Deep knowledge of Self-Directed Care and Financial Management Services (FMS), including data exchange, time sheet rules, service billing, and EVV compliance.
• Experience managing the full product lifecycle, including strategic roadmap development, execution, and continuous improvement.
• Strong expertise in driving OKRs to achieve business goals and operational success.
• Excellent communication and interpersonal skills, with the ability to engage both internal teams and external stakeholders at all levels.
• Analytical and problem-solving abilities, leveraging data to inform decisions and drive improvements.

Preferred:

• Experience with Medicaid/Medicare-funded self-directed care programs or similar managed care programs.
• Familiarity with financial management platforms and technologies.
• Knowledge of accessibility and UX best practices for vulnerable populations.