Remote Senior Product Director, Prior Authorization & UM

Availity; United States; Remote; USD 180,000 - 240,000; Full time

Benefits offered by this job

Competitive salary and bonus structure

Generous HSA company contribution

Comprehensive health coverage

401(k) plan with company match

Unlimited paid time off + 9 holidays

Parental leave for both parents

Gym membership reimbursement

Education reimbursement

Remote work with flexible dress code

Job summary

Availity, a leading healthcare engagement platform, seeks a Senior Product Director, Prior Authorization to guide strategy and scale across the Utilization Management portfolio. This remote US role focuses on cost containment, authorization capabilities, and regulatory alignment.

You will own the roadmap, collaborate with engineering and data teams, and drive innovations in automation and AI-assisted review while balancing access to care and provider/member satisfaction.

Qualifications

• Bachelor’s degree required; advanced degree strongly preferred.
• 10+ years in healthcare product management, medical management or utilization management.
• 5+ years in a senior product leadership role.
• Deep expertise in prior authorization, utilization review and medical cost containment.
• Strong understanding of managed care, payer operations and healthcare regulations.
• Experience with clinical teams and medical policy development.

Responsibilities

• Define and own the long-term product vision and roadmap for medical cost containment and authorization.
• Lead end-to-end product lifecycle from concept through launch, optimization and sunset.
• Translate clinical, operational, and regulatory requirements into clear product requirements.
• Partner with engineering and data teams to deliver scalable authorization and cost containment solutions.
• Ensure products support evidence-based medicine and evolving clinical guidelines.
• Oversee products supporting prior authorization, concurrent and retrospective review.
• Drive automation, rules engines, AI-assisted review, and straight-through processing.
• Quantify savings impact and ROI with Leadership & Finance; support sales and client management.
• Ensure compliance with CMS, NCQA, URAC, DOI, and related regulations.

Skills

Prior authorization

Utilization management

Strategic product leadership

Executive communication

Healthcare payer operations

Education

Bachelor's degree

MBA / MHA / MPH / RN / MD

Job description

Availity, a leading healthcare engagement platform, seeks a Senior Product Director, Prior Authorization to guide strategy and scale across the Utilization Management portfolio. This remote US role focuses on cost containment, authorization capabilities, and regulatory alignment.

You will own the roadmap, collaborate with engineering and data teams, and drive innovations in automation and AI-assisted review while balancing access to care and provider/member satisfaction.