Product Owner: AI in Payment Integrity (Medicare/Medicaid)

Moodys Northwest Consulting; St. Louis (MO); On-site; USD 110,000 - 140,000; Full time

Job summary

Moodys NWC is seeking an innovative Product Owner with deep expertise in Payment Integrity to drive the vision and execution for preventing improper medical payments across government-sponsored programs.

You will combine domain knowledge with a technical background and hands-on experience using AI coding tools to accelerate delivery, draft technical specs, and optimize the product lifecycle. A proactive go-getter mindset is essential.

Qualifications

• Healthcare payer payment integrity experience.
• Knowledge of Medicare/Medicaid adjudication guidelines.
• Proficiency with AI coding tools to accelerate delivery.
• Strong backlog grooming and requirement writing.
• Familiarity with CMS guidelines and reimbursement policies.

Responsibilities

• Own and drive the end-to-end payment integrity roadmap.
• Use AI tools to generate, draft, review, and update technical specifications.
• Collaborate with BSAs and engineering to translate policies into user stories and acceptance criteria.
• Partner with SIU, data science, and clinical reviewers for compliance and accurate post‑adjudication rules.
• Champion modern development practices to improve documentation and team velocity.

Skills

Healthcare domain knowledge

Go-getter attitude

Roadmap definition

Backlog grooming

Cross-functional collaboration

Tools

Windsurf

GitHub Copilot

Job description

Moodys NWC is seeking an innovative Product Owner with deep expertise in Payment Integrity to drive the vision and execution for preventing improper medical payments across government-sponsored programs.

You will combine domain knowledge with a technical background and hands-on experience using AI coding tools to accelerate delivery, draft technical specs, and optimize the product lifecycle. A proactive go-getter mindset is essential.