Remote Lead Product Manager, Interoperability & PA

Humana; United States; On-site; USD 126,000 - 174,000; Full time

Benefits offered by this job

Bonus incentive plan

Competitive benefits

Job summary

Humana is seeking a Lead Product Manager - Interoperability Prior Authorization to drive strategy, roadmap and execution of products that modernize medical and electronic prior authorization experiences across provider and member workflows.

The role emphasizes collaboration with clinical, utilization management, technology, compliance and external partners to deliver compliant, scalable interoperability capabilities that improve information exchange and operational efficiency.

Qualifications

• Minimum of a Bachelor's degree or equivalent experience in a related field.
• 8+ years in Product Management, Healthcare Technology, or similar roles.
• Experience with Medical Prior Authorization and/or Electronic Prior Authorization (ePA).
• Strong knowledge of CMS regulations and interoperability requirements.
• Ability to translate regulatory needs into product features and roadmaps.

Responsibilities

• Define product vision, strategy, and roadmap for Prior Authorization and ePA capabilities.
• Collaborate with stakeholders to improve authorization workflows and provider experiences.
• Translate regulatory and clinical requirements into actionable product plans.
• Lead cross-functional efforts to define requirements, journeys, and success metrics.
• Partner with engineering and delivery teams to ensure timely execution.
• Drive automation and operational efficiency in utilization management and provider workflows.

Skills

Prior Authorization workflows

CMS regulations

Stakeholder management

Cross-functional leadership

Product strategy

Regulatory compliance

Data-driven decision making

Education

Bachelor's degree or equivalent experience

MBA, MHA, RN, PharmD or other advanced degree

Tools

FHIR

HL7

APIs

Interoperability standards

Job description

Humana is seeking a Lead Product Manager - Interoperability Prior Authorization to drive strategy, roadmap and execution of products that modernize medical and electronic prior authorization experiences across provider and member workflows.

The role emphasizes collaboration with clinical, utilization management, technology, compliance and external partners to deliver compliant, scalable interoperability capabilities that improve information exchange and operational efficiency.