Product Owner - Group Health
On-siteFranklin, Tennessee, United States
Job Summary
Translate product priorities, client needs, and regulatory requirements into user stories, acceptance criteria, and development-ready requirements for Commercial Group Health claim processing. Own workflows related to claim scrubbing, large dollar negotiations, PPO network applications, and out-of-network cost containment solutions. Provide day-to-day product decision support during active development cycles, confirm delivered functionality meets business outcomes and regulatory expectations, and support user acceptance testing and training. Partner with Engineering, QA, and Delivery teams to ensure delivery execution while identifying new feature opportunities from internal and external stakeholders.
Required Qualifications
- expertise in Commercial Group Health claim processing
- knowledge of the No Surprises Act
- knowledge of ERISA-related claim considerations
- knowledge of Qualifying Payment Amounts
- knowledge of claim scrubbing
- knowledge of large dollar negotiations
- knowledge of PPO network workflows
- knowledge of out-of-network cost containment solutions
- knowledge of No Surprises Act requirements
- knowledge of ERISA-related claim considerations
- knowledge of Qualifying Payment Amounts
- knowledge of related claim handling processes
- ability to translate product priorities, client needs, regulatory requirements, and operational workflows into user stories, acceptance criteria, and development-ready requirements
- ability to clarify requirements and provide day-to-day product decision support during active development cycles
- ability to confirm delivered functionality meets intended business outcomes, regulatory expectations, acceptance criteria, and user workflow needs
- ability to support user acceptance testing, test scenario review, business readiness confirmation, demos, and training
- ability to act as a product resource for Group Health product functionality, claim workflow, network application, out-of-network processes, and product capabilities
- ability to support Implementation and Client Services through product knowledge transfer, workflow clarification, and client-specific configuration support
- ability to identify new feature opportunities based on feedback from clients, prospects, Sales, Operations, Compliance, Legal, and internal stakeholders
- ability to evaluate enhancement requests to ensure the underlying business problem is understood before defining a solution
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