Product Owner - Group Health

Prime Health Services, Inc.; Franklin (TN); On-site; USD 95,000 - 130,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Short-term/Long-term disability

Group term life insurance

Generous PTO

Wellness program

Job summary

Prime Health Services, Inc. is seeking a Group Health Product Owner to translate priorities into actionable work for Engineering and ensure successful delivery of enhancements to Commercial Group Health solutions.

The role focuses on Group Health claim processing, No Surprises Act compliance, ERISA considerations, including Qualifying Payment Amounts and claim scrubbing, with cross-functional collaboration in an agile environment.

Qualifications

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

Responsibilities

• 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

Skills

Product ownership

Stakeholder collaboration

Agile delivery

Healthcare claims

Backlog tools

Education

Bachelor's degree

Tools

Azure DevOps

Jira

Job description

Description

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 provide 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.