Senior Product Manager

We are seeking a Product Manager to drive the expansion of Oracle Health’s prior authorization and utilization management solution for the United States market.
 

Our existing platform supports healthcare operations across multiple international markets. This role will focus on defining and delivering the capabilities required to meet the unique business, operational, clinical, and regulatory requirements of the U.S. healthcare system. Acting as the product owner for U.S.-specific prior authorization functionality, you will work closely with health plans, healthcare organizations, implementation teams, clinical stakeholders, and internal partners to understand market needs and translate them into product requirements that guide development.
 

A key responsibility of this role is enabling engineering teams to successfully build and deliver U.S. prior authorization and utilization management capabilities. You will engage directly with customers to demonstrate our solution, understand prior authorization, utilization management, and medical management workflows, gather requirements, document business rules, and define functional specifications that support product development. You will serve as the bridge between customers, healthcare domain experts, and engineering teams, ensuring that delivered capabilities align with market expectations and operational realities.
 

The successful candidate will possess deep knowledge of the U.S. healthcare industry and utilization management processes, including prior authorization intake, medical necessity review, clinical decision support, concurrent and retrospective review, care review management, provider collaboration, appeals, and regulatory compliance. They will leverage this expertise to help shape product strategy, prioritize roadmap investments, and ensure our platform can effectively support the needs of U.S. healthcare payers.
 

This is an opportunity to play a key role in bringing a proven global healthcare platform to the U.S. market and helping healthcare organizations modernize prior authorization and utilization management operations through innovative, scalable, and configurable technology.
 

•    Serve as the product domain expert for U.S. prior authorization and utilization management capabilities.
•    Define product vision and roadmap for U.S. prior authorization functionality in partnership with product leadership and engineering.
•    Engage with prospective and existing customers to demonstrate product functionality and communicate the value of Oracle Health’s payer solution platform.
•    Conduct customer workshops, discovery sessions, and requirements-gathering activities with payer and provider stakeholders.
•    Translate customer needs into product requirements, user stories, functional specifications, and other product management artifacts.
•    Collaborate closely with engineering, architecture, UX, implementation, and clinical teams to define solution designs and clarify business requirements.
•    Support development teams by providing healthcare prior authorization expertise and validating proposed solutions.
•    Analyze market requirements and identify product enhancements needed to support U.S. healthcare payer operations.
•    Prioritize roadmap investments based on customer value, regulatory impact, operational urgency, and strategic fit.
•    Monitor evolving regulatory, interoperability, and industry standards that affect prior authorization and utilization management workflows.
 

Required Qualifications
•    Experience with healthcare payer operations in the areas of prior authorization and utilization management.
•    Deep understanding of the U.S. healthcare industry, payer workflows, and utilization management processes.
•    Experience in product management, business analysis, healthcare consulting, payer operations, or a related role.
•    Proven ability to gather, document, and prioritize complex business and functional requirements.
•    Strong customer-facing, presentation, and stakeholder management skills.
•    Ability to translate complex healthcare operational requirements into software capabilities and functional solution designs.
 

Preferred Qualifications
•    Experience with commercial, Medicare, Medicaid, or government healthcare programs.
•    Familiarity with healthcare claims and authorization standards, including X12 transactions and related payer workflows.
•    Knowledge of prior authorization APIs, interoperability patterns, and healthcare data exchange standards such as FHIR and HL7.
•    Awareness of current U.S. prior authorization and interoperability requirements, including regulatory and accreditation expectations.
•    Experience working in Agile software development environments.
•    Knowledge of modern utilization management systems, care man