Product Manager, Eligibility & Coverage

Jobf0; United States; Hybrid; USD 180,000 - 230,000; Full time

Benefits offered by this job

Great compensation package and bonus

Medical, dental, vision, and 401K

Remote, hybrid or in-office work

Volunteer time off and 12 paid hols

Job summary

Experian is seeking a Senior Product Manager to lead the strategy and roadmap for hospital eligibility verification, coverage discovery, and payer connectivity. You will independently guide an engineering team of roughly 3–8 engineers and serve as the primary point of contact for health-system customers on eligibility and coverage questions.

You will drive market research, shape a long-term roadmap, and build business cases for high-impact initiatives such as expanding payer coverage and

Qualifications

• 3+ years of product management experience including end-to-end ownership of a product area.
• Experience in healthcare IT, revenue cycle management, or health insurance/payer operations with familiarity in eligibility verification or coverage discovery.
• Experience guiding an engineering team (3–8 engineers) and owning a roadmap.
• Proficiency in data analysis and AI-assisted analysis to validate decisions and prioritize work.
• Experience leading customer-facing meetings, presenting roadmaps, and negotiating scope with stakeholders.
• Hands-on experience with AI tools spanning chat-based assistants and prototyping tools.
• Familiarity with healthcare regulatory and data-protection requirements (HIPAA, EDI).
• Reside in or near Collaboration Hub locations.

Responsibilities

• Own the eligibility verification, coverage discovery, and payer connectivity capabilities used by hospitals and health systems.
• Drive market research to identify needs and shape a long-term roadmap with compelling business cases.
• Monitor product and payer-response performance using analytics and AI to improve accuracy of eligibility data.
• Lead an engineering team of 3–8 engineers delivering eligibility and coverage products, guiding delivery and quality decisions.
• Collaborate with engineering and design leadership to resolve trade-offs when integrating payer connections and data sources.
• Leverage agentic AI and dev-integrated tools to accelerate discovery, prototyping, and embedding AI into the product.
• Lead customer meetings, present the roadmap, gather feedback, and negotiate competing requests for the broader strategy.
• Manage complex relationships across engineering, compliance, payer operations, health-system customers, and payer partners, ensuring HIPAA and data protection compliance.

Skills

Product management

Healthcare IT

Data analysis

Leadership

Roadmap ownership

AI tools familiarity

Customer meetings

Regulatory knowledge (HIPAA)

Job description

This role drives the strategy and roadmap for the products that hospitals and health systems use to verify a patient's insurance eligibility, discover undisclosed coverage, and understand the complete picture of a patient's benefits. You'll independently guide an engineering team of roughly 3-8 engineers and serve as a primary point of contact for health-system customers on eligibility and coverage questions.

Location

At Experian, we believe great work happens when people come together. We're focused on attracting talent in and around our designated hub locations who are open to collaborating with colleagues in person. Aligning employees to these talent markets helps foster collaboration, strengthen team connections, and support long-term career growth within Experian. You will report to the Sr. Director of Eligibility & Coverage, and reside in or near one of our collaboration hubs:

Costa Mesa, CA; San Jose, CA; Allen, TX; Austin, TX; Franklin, TN; New York, NY; Schaumberg, IL; Washington, D.C.; Atlanta, GA; Boston, MA; Seattle, WA

You will have opportunity to:

• Own the eligibility verification, coverage discovery, benefits summarization and interpretation, and payer connectivity and data-source capabilities that hospitals and health systems rely on to understand a patient's complete insurance picture.
• Drive market research and data analysis to identify customer needs and trends in eligibility verification and coverage discovery, shaping a long-term roadmap and building business cases for high-impact initiatives like expanding payer coverage or adding new data sources.
• Monitor product and payer-response performance, using analytics - increasingly AI-accelerated - to identify where eligibility responses are incomplete, ambiguous, or wrong, and to validate which data sources most improve coverage discovery accuracy.
• Independently guide an engineering team of roughly 3-8 engineers delivering eligibility and coverage discovery products, owning delivery and quality decisions.
• Partner closely with engineering and design leadership to resolve complex trade-offs in integrating new payer connections and eligibility data sources.
• Use agentic AI and dev-integrated tools (such as Cursor and Cowork) to accelerate discovery, requirements, and prototyping, and look for opportunities to responsibly embed AI into the product itself.
• Lead customer meetings, present the roadmap, gather feedback, and negotiate competing requests in service of the broader product strategy.
• Manage complex relationships across engineering, compliance, and payer operations, as well as health-system customers and payer partners, and apply healthcare regulatory knowledge (HIPAA, X12 EDI standards, CMS interoperability rules) to manage compliance and risk.

Qualifications

• 3+ years of product management experience, including experience owning a product area end-to-end.
• Experience in healthcare IT, revenue cycle management (RCM), or health insurance/payer operations - direct experience with patient eligibility verification (270/271 EDI transactions) or coverage discovery strongly preferred.
• Experience independently guiding an engineering team (roughly 3-8 engineers) and owning a product roadmap.
• Experience using data analysis, including AI-assisted analysis, to validate assumptions and prioritize product decisions.
• Experience leading customer-facing meetings, presenting roadmaps, and negotiating scope with external stakeholders.
• Hands-on experience with AI tools spanning chat-based assistants, agentic tools, and dev-integrated/prototyping tools.
• Familiarity with healthcare regulatory and data-protection requirements (e.g., HIPAA, EDI standards).
• Reside in, or near the designated Collaboration Hub(s) for this role.

Additional Information

Our uniqueness is that we celebrate yours. Experian's people first, inclusive and purpose driven culture is multi award-winning; World's Best Workplaces™ 2025 (Fortune Global Top 25), Great Place To Work™ in 26 countries to name a few. Check out Experian Life on social or explore our Careers Site to understand why.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
• Explore all our exciting benefits here: https://myexperianbenefits.com/

Company Description

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets, from financial services to healthcare, automotive, agribusiness, insurance, and many more. Experian invests in people and new advanced technologies to unlock the power of data. We have an amazing team of 25,200 people in 32 countries.