Head of Product, Virtual Care [Remote]

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.
At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding.

Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

We are seeking a Product Manager with expertise in prior authorization workflows and interoperability. This role will focus on implementing interoperable solutions that streamline prior authorizations, medical necessity reviews, and payer-provider workflows while ensuring compliance with regulatory guidelines. The ideal candidate will bridge the gap between business and technical teams to optimize prior authorization processes and reporting capabilities.

You will serve as the subject matter expert (SME) for prior authorization workflows and interoperability standards, bridging business and technical teams to deliver innovative solutions that meet CMS mandates and industry needs.

Work on cutting-edge solutions that have the potential to reshape prior authorization processes across the healthcare industry.

Deep expertise in prior authorizations workflows. Strong technical background with an understanding of the CMS 0057-F requirements for prior authorization and the X12 278 EDI and FHIR prior authorization (CRD, DTR, and PAS) transactions.

Knowledge of EHR systems and utilization management platforms and vendors.

Technical acumen, the ability to gather and describe market requirements and get feedback from technical staff and customers.

Familiarity with regulatory requirements and compliance standards.

Proficiency in analyzing data and finding actionable insights.

Product Strategy & Vision: Define and communicate a clear product roadmap aligned with CMS requirements, industry trends, and organizational goals.

Requirements & Specifications: Gather and document business requirements through stakeholder interviews and workflow analysis. Cross-Functional Leadership: Collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases.

Serve as the subject matter expert on prior authorization workflows and FHIR standards; Customer & Market Insight: Monitor CMS mandates, industry trends, and client feedback to inform product decisions and prioritize features.

Define product performance metrics and partner with data teams to deliver actionable insights for ROI and gainshare.

We have many resources and experts in our tech stack and in our industry that can help get you there too!

Cool, you can wear jeans - we are a casual place.

We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!

We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.

We offer education reimbursement!

Want to work for an organization that gives back to the community? Recruiter Recorded Video Pre-Screen

Video Interview with Hiring Manager

Panel Video Interview

Final Video with Hiring Manager

Video Camera Usage:
As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.
Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.
Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.
Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Family& Medical LeaveAct Equal Employment Law PosterPay TransparencyEmployee Polygraph Protection Act IER Right to Work Poster Important Notice about Employee Rights to Organize and Bargain Collectively with Their Employers

#