Capitation Adjudication Product Manager (Remote)

IQVIA LLC; Houston (TX); Remote; USD 88,000 - 220,000; Full time

Job summary

Cedar Gate Technologies, an IQVIA business, seeks a Product Manager to enhance and deliver the Capitation Adjudication platform. This role requires deep payer operations knowledge and hands‑on Capitation Adjudication experience in production environments.

You will drive requirements, manage backlogs, and collaborate with cross‑functional teams to ensure client satisfaction. You will work with Product, Engineering, QA, Operations, Client Services, and Implementations to guide delivery and

Qualifications

• Bachelor’s degree in Healthcare Administration, Information Systems, Business Administration, or related field, or equivalent experience.
• Seven or more years of experience in healthcare payer, managed care, or health plan operations.
• Five or more years of hands‑on experience working with Capitation Adjudication (like EZ‑CAP) in a production environment.
• Experience supporting payer operations after go‑live, including ongoing production support, issue resolution, process improvements, or system enhancements.
• Experience gathering business requirements and translating them into functional solutions.
• Strong understanding of healthcare claims processing, capitation administration, provider reimbursement, or managed care operations.
• Experience working in Agile or Scrum-based software development environments.

Responsibilities

• Manage and prioritize product enhancements and backlog items for the Capitation Adjudication platform.
• Develop user stories, functional requirements, and acceptance criteria.
• Collaborate with engineering and quality assurance teams throughout the software development lifecycle.
• Participate in Agile planning activities, backlog refinement sessions, sprint reviews, and release preparation.
• Help evaluate product enhancements through the lens of real-world payer operations and client needs.
• Support implementation, testing, release readiness, and post-release activities.
• Partner with internal stakeholders to identify opportunities for product improvements and operational efficiencies.
• Assist with product demonstrations, client discussions, and subject matter expertise related to Capitation Adjudication functionality.
• Contribute to product roadmap planning through feedback from clients, operational teams, and market requirements.

Skills

Healthcare payer

Agile / Scrum

Requirements gathering

Stakeholder mgmt

Communication

Education

Bachelor's degree

Tools

JIRA

Confluence

SQL

Reporting tools

Job description

Cedar Gate Technologies, an IQVIA business, seeks a Product Manager to enhance and deliver the Capitation Adjudication platform. This role requires deep payer operations knowledge and hands‑on Capitation Adjudication experience in production environments.

You will drive requirements, manage backlogs, and collaborate with cross‑functional teams to ensure client satisfaction. You will work with Product, Engineering, QA, Operations, Client Services, and Implementations to guide delivery and