Remote Product Manager — Capitation Adjudication Platform

IQVIA Argentina; Houston (TX); Remote; USD 88,000 - 220,000; Full time

Job summary

Cedar Gate Technologies, an IQVIA business, is seeking a Product Manager to enhance and deliver the Capitation Adjudication platform for health plans. You will translate payer operations into product requirements and work with Product, Engineering, QA, Operations, Client Services and Implementations to drive outcomes.

This role requires 7+ years in health plan operations, hands-on Capitation Adjudication experience, strong Agile skills, and the ability to communicate with stakeholders.

Qualifications

• Bachelor's degree in Healthcare Administration, Information Systems, Business Administration, or a related field, or equivalent experience.
• Seven or more years of experience in healthcare payer, managed care, or health plan operations.
• Five or more years of hands-on experience with Capitation Adjudication (EZ-CAP) in production.
• Experience supporting payer operations after go-live, including ongoing production support, issue resolution, process improvements, or system enhancements.
• Experience gathering business requirements and translating them into functional solutions.
• Strong understanding of healthcare claims processing, capitation administration, provider reimbursement, or managed care operations.
• Excellent communication, organizational, and stakeholder management skills.
• Experience working in Agile or Scrum-based software development environments.
• Experience supporting multiple functional areas within Capitation Adjudication, such as claims, authorizations, capitation, benefits, provider administration, or EDI is preferred.
• Experience with value-based care, risk-based payment models, or capitated products is highly preferred.
• Previous experience supporting Cedar Gate Technologies' Capitation Adjudication platform, EZ-Cap, from the client side, would be the ideal preferred candidate.
• Experience participating in implementation projects, upgrades, conversions, or major system enhancements would be nice.
• Some familiarity with JIRA, Confluence, SQL, reporting tools, or healthcare operational reporting.
• Certified Scrum Product Owner (CSPO), Agile certification, or similar professional certifications are preferred.
• To be eligible for this position, you must reside in the same country where the job is located.

Responsibilities

• Manage and prioritize enhancements and backlog for Capitation Adjudication.
• Gather, analyze, and document business requirements and use cases.
• Develop user stories, functional requirements, and acceptance criteria.
• Collaborate with engineering and quality assurance teams throughout the software development lifecycle.
• Participate in Agile planning activities, backlog refinement sessions, sprint reviews, and release preparation.
• Help evaluate product enhancements through the lens of real-world payer operations.
• Support implementation, testing, release readiness, and post-release activities.
• Partner with internal stakeholders to identify opportunities for product improvements and operational efficiencies.
• Assist with product demonstrations, client discussions, and subject matter expertise related to Capitation Adjudication functionality.
• Contribute to product roadmap planning through feedback from clients, operational teams, and market requirements.

Skills

Communication

Stakeholder management

Organizational skills

Agile/Scrum experience

Requirements gathering

Education

Bachelor's degree in Healthcare Administration, Information Systems, Business Administration, or a related field

CSPO Certification

Tools

JIRA

Confluence

SQL

Reporting tools

Job description

Cedar Gate Technologies, an IQVIA business, is seeking a Product Manager to enhance and deliver the Capitation Adjudication platform for health plans. You will translate payer operations into product requirements and work with Product, Engineering, QA, Operations, Client Services and Implementations to drive outcomes.

This role requires 7+ years in health plan operations, hands-on Capitation Adjudication experience, strong Agile skills, and the ability to communicate with stakeholders.