Product Owner - Group Health

Prime Health Services; Franklin (TN); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Disability insurance

PTO

Job summary

Prime Health Services seeks a Group Health Product Owner who will serve as the subject matter expert for Commercial Group Health solutions and translate priorities into actionable work for Engineering. You will support sprint readiness, demos, training, and stakeholder walkthroughs while partnering with cross-functional teams to improve product outcomes.

The role requires experience in Group Health claims, No Surprises Act, ERISA, and cost containment concepts, with a strong focus on delivering

Qualifications

• 5+ years in product ownership, analysis, operations, or healthcare tech
• Experience with Commercial Group Health or claims processes preferred
• Knowledge of No Surprises Act, ERISA, and cost containment concepts preferred

Responsibilities

• Serve as the product subject matter expert for Group Health solutions
• Translate business needs and client requests into clear product requirements
• Support claim-related solutions involving PPO networks and out-of-network claims
• Provide day-to-day product clarification and decision support during development
• Partner with Product Analysts, Engineering, QA, and the Agile Delivery Manager
• Support user acceptance testing, validation, product demos, training
• Serve as a product resource for internal teams on Group Health solutions
• Support Implementation and Client Services through knowledge transfer
• Identify product improvement opportunities from feedback

Skills

Backlog management

Agile delivery

Cross-functional collaboration

Requirements translation

Communication

Education

Bachelor's degree in a related field

Tools

Azure DevOps

Jira

Job description

About this position

The Group Health Product Owner serves as the subject matter expert for Prime Health's Commercial Group Health solutions. Reporting to the Director of Product, this role is responsible for translating product priorities and business needs into clear, actionable work for Engineering and supporting the successful delivery of enhancements, features, and product improvements. This role requires expertise in Commercial Group Health claim processing, including the No Surprises Act, ERISA-related claim considerations, Qualifying Payment Amounts, claim scrubbing, large dollar negotiations, PPO network workflows, and out-of-network cost containment solutions.

What You'll Do

• Serve as the product subject matter expert for assigned Group Health solutions and product functionality
• Translate business needs, client requests, and operational workflows into clear product requirements
• Support claim-related solutions involving PPO networks, out-of-network claims, claim scrubbing, large dollar claim review, No Surprises Act, ERISA, and Qualifying Payment Amount concepts
• Provide day-to-day product clarification and decision support during development
• Partner with Product Analysts, Engineering, QA, and the Agile Delivery Manager to support sprint readiness and delivery execution
• Support user acceptance testing, validation, product demos, training, and stakeholder walkthroughs
• Serve as a product resource for internal teams when questions arise about Group Health solutions, functionality, or client-specific needs
• Support Implementation and Client Services through product knowledge transfer and workflow clarification
• Help identify product improvement opportunities based on feedback from clients, prospects, and internal stakeholders

Requirements:

What We're Looking For

• Bachelor's degree in Business, Healthcare Administration, Information Systems, Product Management, or a related field preferred
• 5+ years of experience in a Product Owner, Product Analyst, Business Analyst, Operations, Claims, Network, or healthcare technology role
• Experience in Commercial Group Health, healthcare claims, PPO networks, out-of-network solutions, medical bill review, claim repricing, or cost containment strongly preferred
• Experience with No Surprises Act, ERISA, Qualifying Payment Amounts, claim scrubbing, large dollar negotiations, PPO network application, or out-of-network claim handling preferred

Competencies

• Ability to translate business needs and workflow requirements into clear functional requirements
• Experience working with cross-functional teams in an agile delivery environment
• Strong communication, collaboration, and problem-solving skills
• Ability to clarify requirements and provide timely product direction during active development cycles
• Strong attention to detail and ability to manage multiple priorities
• Familiarity with backlog management tools such as Azure DevOps, Jira, or similar platforms preferred

Why You'll Love Working at Prime Health Services

• Medical Insurance (high deductible plan with an HSA)
• Dental Insurance
• Vision Insurance
• Short-term and long-term disability paid by the company
• Group term life paid by the company
• Generous PTO
• Wellness program with monetary rewards
• Employee recognition programs with monetary rewards
• Corporate office amenities - specialty coffee machines, assorted tea options, smoothie bar, collaborative workspaces, fruit provided by company and an onsite market
• Regular employee events

About Prime Health Services

Prime Health Services (PHS) is a national medical cost containment company specializing in customized PPO network solutions. Since 2001, we've partnered with insurance carriers, TPAs, self-insured groups, and government entities to deliver high-quality healthcare access at discounted rates. Our technology-driven approach allows us to provide fast, flexible, and dependable service to our clients while supporting a collaborative, employee-focused workplace.