Product Manager, Interoperability

About the Role

Interoperability is no longer a compliance checkbox for health plans — it's fast becoming the operating model for how payers, providers, members, and other plans move data between them, and the requirements behind that shift are real. We are looking for a Product Manager to help lead our Interoperability portfolio: the point where regulation, clinical and claims data, and payer operations meet, and one of the most demanding, highest-stakes product problems in healthcare today.

Our platform delivers the APIs, data pipelines, portals, and consent capabilities that health plans and state programs depend on to meet CMS mandates and exchange data reliably across wildly different states, plan types, and technology environments. Our clients are counting on us to get this right, which is exactly why this role carries real weight from day one.

In this role, you will work alongside our existing Interoperability product lead and take real ownership of a substantial part of the portfolio — not a queue of someone else's decisions to execute, but genuine senior scope. You will set direction for the capabilities you own, interpret regulation, shape requirements, and drive open questions to closure yourself, on a team that treats your judgment as the reason you were hired.

The work spans the full interoperability picture rather than a single API or a single mandate. That includes Patient Access, Provider Access, Payer-to-Payer exchange, electronic prior authorization, consent and member attribution, the FHIR data and platform layer underneath all of it, and the portals, identity, and reporting capabilities that make it usable and auditable. It also includes what comes next: drug electronic prior authorization, provider directory requirements, and evolving HL7 and USCDI standards.

Within a few months, you're the person Engineering, Delivery, and Client Success come to for the capabilities you own. Within a year, you're setting the roadmap for those areas, not just running it.

Your day to day

• Own interoperability capabilities end to end. Take direct ownership of defined product areas across Patient Access, Provider Access, Payer-to-Payer exchange, electronic prior authorization, consent and attribution, or the platform capabilities that support them. Set strategy and roadmap priorities for your areas and partner with the existing product lead on the portfolio as a whole.
• Translate regulation into product. Read CMS rules and HL7 FHIR implementation guides closely, work out what they actually require of a payer platform, and turn that into product direction our teams and clients can act on. Distinguish what is mandated from what is a client preference, and document the reasoning so decisions hold up later.
• Define the work clearly. Produce PRDs, epics, user journeys, workflows, requirements, user stories, and acceptance criteria that engineering can build from and QA can test against. Write for people who were not in the room.
• Make the call and unblock people. Triage questions from Engineering, Delivery, QA, Sales, Client Success, clients, and external partners. Separate genuine product gaps from configuration, data quality, testing, and education issues, then either decide or drive the decision to closure quickly.
• Partner with Engineering and Architecture. Work with technical teams on API design, bulk data performance, FHIR mapping and validation, identity and authorization, observability, audit logging, and error handling. You do not need to write the code, but you do need to reason about the tradeoffs.
• Protect the standard product. Evaluate enhancement and customization requests for product fit, reuse potential, compliance implications, and commercial value. Guide implementation teams toward configurable, reusable solutions and push back on one-off work that weakens the platform.
• Support delivery through go-live and beyond. Contribute to release planning, implementation readiness, UAT, go-live, and stabilization. Stay engaged after launch to learn what worked, what did not, and what the next release should fix.
• Improve how we all work. Strengthen implementation playbooks, testing guidance, product documentation, FAQs, and internal enablement for Product, Engineering, Delivery, Sales, QA, and client-facing teams.
• Look ahead. Track changes across CMS rulemaking, HL7 FHIR, Da Vinci, CARIN, and the wider interoperability market. Use API usage data, implementation insights, support trends, and client feedback to guide where we invest next, and grow into ownership of emerging mandates as the portfolio expands. Build upon this strong foundation, and look for novel ways to introduce new value to payers including complementing high value AI and data-driven use cases.

What you bring to the team

• 5 to 10 years in product management, with meaningful time in US healthcare technology, payer data, or healthcare interoperability.
• Practical working knowledge of CMS-9115 and CMS-0057, and enough awareness of emerging interop mandates to reason about what they will require.
• Solid grounding in HL7 FHIR R4, REST APIs, OAuth 2.0, bulk data exchange, and healthcare identity. Familiarity with the implementation guides that matter here, including Da Vinci, CARIN Blue Button, US Core, Plan-Net, and US Drug Formulary. We do not expect depth in every guide.
• A track record of defining and launching healthcare SaaS, API, data, or interoperability products.
• The ability to work credibly with Engineering, Architecture, QA, Security, Data, and Implementation teams without being a software developer yourself.
• Strong investigative instincts. You can take an ambiguous problem, find the real product decision inside it, and make a clear recommendation.
• Direct experience with external product partners, vendors, senior stakeholders and payer clients.
• Sound judgment about where to standardize, where to configure, and where customization is genuinely warranted, especially on multi-client products with shared capabilities and client-specific constraints.
• Comfort working across US and international teams at pace, with a proactive, calm, accountable, and hands-on style.
• Experience with Jira, Confluence, Productboard, and Agile or Scrum delivery.
• Bachelor's degree in a technical, healthcare, engineering, or business field, or equivalent relevant professional experience.

What we would like to see, but not required

• Experience with Medicaid, Medicare Advantage, Blues, or commercial lines of business, including the differences in how each implements interoperability.
• Hands-on exposure to FHIR server platforms and cloud-native deployment on AWS or Azure.
• Familiarity with Databricks or comparable data and platform technologies.
• Background in EMPI, MDM, identity resolution, member matching, or consent management.
• Experience with prior authorization, payer to provider exchange, or large-scale healthcare data transformation.
• Exposure to T-MSIS, MMIS, NCPDP, or X12 EDI data, as well as HEDIS dQM
• Experience with API and portal identity patterns such as OIDC, SAML, client credentials, mTLS, and SSO.

Compensation: Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.

What you’ll get in return

• Unlimited paid time off – recharge when you need it
• Work from anywhere – flexibility to fit your life
• Comprehensive health coverage – multiple plan options to choose from
• Equity for every employee – share in our success
• Growth-focused environment – your development matters here
• Home office setup allowance – one-time support to get you started
• Monthly cell phone allowance – stay connected with ease