Principal Payment Integrity Product Manager

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

 

As a Payment Integrity Product Manager at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• Lead the development of new Payment Integrity product ideas and enhancement of existing products
• Oversee the design, pricing, and marketing of Payment Integrity products and services throughout their lifecycle
• Develop or lead the creation of technical models to guide Payment Integrity project engagements of various complexities
• Gather, analyze, and prioritize Payment Integrity product and customer requirements; define product vision; and work with IT to oversee product design, enhancements, and quality
• Establish milestones, manage deliverables, and coordinate completion for all product-related deliverables
• Act as the Payment Integrity contact for customer product and operational requirements, maintaining relationships with customers, brand management, and development teams
• Serve as a subject matter expert, ensuring Payment Integrity product design and deployment adhere to client and company guidelines
• Work with cross functional teams, consultants, and professional services to enhance client relationships and product sales
• Lead efforts to influence client expectations and ensure satisfaction in product-related issues
• Maintain revenue forecast information, identify financial fluctuations, adjust strategies, and ensure financial commitments are met
• Track market trends, evaluate competitive offerings, and analyze the competitive landscape to shape Payment Integrity product direction
• Lead business cases for optimizing existing Payment Integrity products or creating new product generations
• Collaborate with research and development to define and validate new products

What we're looking for

• 8+ years in product management, technical support, or consulting with Payment Integrity systems.
• 5+ years in Payment Integrity audit and recovery, including Data Mining, Clinical Medical Record Review, and Bill Audit.
• Familiar with technology architecture, business operations, and client-specific Payment Integrity processes.
• Proficient in development tools, analytical techniques, problem-solving, and decision-making.
• Skilled in prioritizing and balancing multiple tasks effectively.

What you should expect in this role

• Fully Remote Opportunity
• Opportunities to travel through your work (0-10%)
• Interesting and challenging work that would contribute to helping those that are most vulnerable in the healthcare (State Medicaid members) industry

Note

• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• The deadline to submit applications for this posting is 2/24/2025

. <p>The pay range for this position is $108,500.00 - $155,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You&rsquo;ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a&nbsp;<u><a href="https://jobs.gainwelltechnologies.com/content/benefits/?locale=en_US">401(k) employer match, comprehensive health benefits</a></u>, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.</p> <p>&nbsp;</p> <p>We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry