Product Owner - Expert Claims Review

At Zelis, we Get Stuff Done. So, let’s get to it!

A Little About Us

Zelis is modernizing the healthcare financial experience for all by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients.

A Little About You

You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview

The Expert Claims Review Product Owner is a key member of the Price Optimization business unit, who should be able to operate within and help drive an Agile Scrum Team as well as being capable of leading & driving small to large scale initiatives outside of the Agile Scrum structure. This Product Owner will be working within the Expert Claims Review Product team and aligned with the Expert Claims Review operational team with a focus on Itemized Bill Review, Clinical Chart Review, and Document Retrieval for both pre-payment and post-payment products. This position will work in close partnership with Business Operations, Ideation, Sales, IT, and Implementation departments in the development and maintenance of the current product(s) as it relates to scalability, functionality, and initiatives imperative to growth. This position also oversees business processes including support for communication, documentation, and knowledge transfer for release and operational support readiness. Enhancements to operational efficiencies, technology advances and process improvements will be a key focus of this role.

Within Agile Team
As a member of the Agile Team, the Product Owner is responsible for partnering with our Business Analysts in defining all User Stories, Acceptance Criteria, and helping the team keep on track with iteration delivery. This role has significant relationships and responsibilities outside the local team, including working with Product Management, Customers, Business Owners, and other internal stakeholders.

Outside the Agile Team
The Product Owner is a member of the Enterprise Product Team and has direct accountability for operationalizing a Market In product strategy that is inclusive of competitive analysis, market assessment, operational and technical roadmaps, as well as sales and enterprise goals. This accountability includes proactive identification of roadmap capabilities, joint prioritization of intake requests, as well as collaboration across leadership teams to ensure alignment and validation.

Additionally, some initiatives may be run as projects outside the Agile execution structure and the candidate must be able to demonstrate experience in managing & driving medium to complex sized projects, unsupervised. This should include knowledge of project management techniques, including managing issues, risk mitigation, planning, etc.

What You’ll Do

• Contribute to the end-to-end Product Lifecyle Management for responsible Products.

• Maintain a deep understanding of the business needs and the factors driving the impact and priority.

• Support and analysis in ensuring data driven delivery of product roadmap; Return on Investment assessment, business impact analysis, goal alignment, operational impact analysis, etc.

• Translating these business needs into User Stories which the Agile team can understand and work from.

• Applying the concepts of Minimum Viable Product (MVP), to shape “what to work on next.” 

• Being able to take the initiative and make decisions, to keep the team moving forward.

• Preparation and Participation in PI Planning

  • As a member of the extended Product Management team, the Product Owner is heavily involved in program backlog refinement and prep for Program Increment (PI) planning and plays a significant role in the planning event itself.

• Sprint Execution

  • Maintaining the team backlog – With input from System Architect/Engineering and other stakeholders, the Product Owner has the primary responsibility for building, editing, and maintaining the team backlog.

  • Sprint P