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Job Details

Lead Product Manager - Healthcare API

Location
Albuquerque, NM, United States

Posted on
Dec 10, 2021

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Job Information
Humana
Lead Product Manager - Healthcare API
in
Albuquerque
New Mexico
Description
The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly responsible for providing insight, advisement and direction to teams responsible for Enterprise API catalog, developer experiences, and integration systems. Individual will be leveraging previous healthcare experience to aid in the discovery, design, implementation, and presentation of current and future state workflows in an effort to provide simple and efficient member experiences.
Responsibilities
Responsibilities:
Participation and accountability in the overall strategy and direction of Humana's Enterprise API portfolio and deeply involved thought leader within multiple business and IT segments
Influencing the direction, design and implementation of new process, workflows, and experiences
Aiding in analyzing, assessing and auditing Enterprise API content in assuring alignment to business and regulatory standards
Proactively detecting issues and identifying solutions with directly responsible Individuals
Continuously researching, synthesizing and presenting latest industry standard, policy, and regulation to the collective Enterprise API & Integration teams
Education/Experience:
Bachelors degree
10 years of related experience supporting large-scale Healthcare payers
Direct experience working in or with healthcare payers and providers for multiple lines of business: Medicare, Medicaid, Commercial - Individual & Group, etc
In-depth knowledge and work experience in two or more of the following healthcare functions:1. Member eligibility or enrollment2. Provider data management3. Clinical care or utilization management (UM)4. HEDIS Quality measurements5. Value-based care6. Regulatory and compliance7. Claims management
Deep understanding of insurance and clinical process flows, systems and operational procedures
Heightened awareness of healthcare best practice and industry standards in order to directly influence future state direction
Strong experience in creating, capturing, and analyzing business and/or IT requirements and mapping them to existing or future state workflows
Proven ability leading cross-functional design & discovery sessions to help identify existing problems, collaborate on potential solutions, and map to desired business processes based on technology roadmap
Understanding of advanced analysis processes including opportunity assessments, trend identification, and gap analysis
Additional Information
Will report to the Director, Product Management, IT TA - Enterprise Architecture
For this job, associates are required to be fully COVID vaccinated (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination or commit to testing protocols
*OR  *
Provide proof of applicable exemption including any required supporting documentation
​​Medical, religious, state and remote-only work exemptions are available.
Scheduled Weekly Hours
40

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