CLINICAL PRODUCT OWNER (PRIOR AUTHORIZATIONS SME)
Glint Tech Solutions
CLINICAL PRODUCT OWNER (PRIOR AUTHORIZATIONS SME)
COMPANY OVERVIEW
Glint Tech Solutions is a women-owned global staffing and IT recruiting firm dedicated to connecting exceptional talent with industry-leading opportunities across the US and beyond. We partner with top-tier clients across healthcare, technology, finance, and logistics to place high-caliber professionals in roles that truly make an impact.PROJECT DESCRIPTION
Our client is seeking a highly experienced Clinical Product Owner and Business Integration Lead with deep expertise in clinical prior authorizations to drive a complex, cross-functional initiative focused on the complete analysis and potential redesign of the prior authorization process. This is a lead-level, fully remote position requiring a true SME in Prior Authorizations, FACETS, 278 transactions, and Claims Processing. The ideal candidate brings 15+ years in healthcare and payer operations, with the last 8+ years in a Clinical Product Manager capacity. Day-to-day responsibilities include engaging clinical, business, and IT stakeholders to analyze current PA workflows, identify pain points, and drive meaningful process improvements.KEY RESPONSIBILITIES
Lead cross-functional meetings with clinical, business, and IT stakeholders to analyze current prior authorization processes Identify pain points and drive resolutions to improve PA workflows end-to-end Support complete analysis and potential redesign of the client's prior authorization process Serve as primary SME for Clinical Prior Authorizations, FACETS, 278 transactions, and Claims Processing Deliver executive-level reporting and manage complex, multi-stakeholder initiatives Translate clinical and business requirements into actionable product and integration strategiesMANDATORY SKILLS
15+ years in healthcare delivery, payer operations, UM, or PA programs Last 8+ years as a Clinical Product Manager or Business Integration Lead End-to-end knowledge of Clinical Prior Authorizations — critically important FACETS expertise Claims processing knowledge 278 transaction experience Basic working knowledge of GuidingCare Excellent communication, stakeholder management, and executive-level reporting skills Must be US-basedNICE-TO-HAVE SKILLS
Experience leading prior authorization process redesign initiatives Background working with large healthcare payers or managed care organizations Familiarity with UM/PA regulatory and compliance frameworks #J-18808-Ljbffr Glint Tech SolutionsVacancy posted 1 day ago
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