Product Manager, Capitation Adjudication (Remote)

IQVIA; Houston (TX); On-site; USD 88,000 - 220,000; Full time

Job summary

Cedar Gate Technologies, an IQVIA business, is seeking a Product Manager to enhance and deliver the Capitation Adjudication platform. Ideal candidates have direct health plan or managed care experience and understand payer operations, claims processing, and capitation management.

You will collaborate with Product, Engineering, QA, Operations, Client Services, and Implementations to drive outcomes for a growing client base, shaping the roadmap with client and market input. Remote US location.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• 7+ years in healthcare payer, managed care, or health plan operations.
• 5+ years with Capitation Adjudication (e.g., EZ-CAP) in production.
• Experience supporting payer operations post go-live and in production improvements.
• Experience gathering requirements and translating to functional solutions.
• Understanding of claims processing, capitation, and managed care operations.
• Experience in Agile or Scrum software development environments.

Responsibilities

• Manage and prioritize enhancements and backlog for Capitation Adjudication platform.
• Gather and document business requirements and operational use cases.
• Develop user stories, functional requirements, and acceptance criteria.
• Collaborate with engineering and QA through the software lifecycle.
• Participate in Agile planning, backlog refinement, and sprint reviews.
• Support implementation, testing, release readiness, and post-release activities.
• Identify opportunities for product improvements and operational efficiencies.
• Assist with demonstrations, client discussions, and subject matter expertise.

Skills

Capitation Adjudication

Healthcare payer

Product management

Agile / Scrum

CSPO certification

JIRA

Confluence

SQL

Education

Bachelor's degree in Healthcare Administration / Information Systems / Business Administration

Tools

JIRA

Confluence

SQL

Job description

Cedar Gate Technologies, an IQVIA business, is seeking a Product Manager to enhance and deliver the Capitation Adjudication platform. Ideal candidates have direct health plan or managed care experience and understand payer operations, claims processing, and capitation management.

You will collaborate with Product, Engineering, QA, Operations, Client Services, and Implementations to drive outcomes for a growing client base, shaping the roadmap with client and market input. Remote US location.