Senior Product Owner: Payer Claims & Grouper

Fractal Analytics Inc

California

On-site

USD 170,000 - 200,000

Full time

4 days ago

Be an early applicant

Get a reply from this employer

Your resume and cover letter, tailored to exactly what they’re hiring for.

Get past ATS filters

Job summary

Fractal Analytics Inc. is seeking a Senior Product Owner for Clinical Claims & Grouper Solutions. You will shape a clinical claims data product for payer clients, guiding requirements across clinical policy, actuarial, analytics, and data engineering teams.

You will translate needs into BRDs, user stories, and validation criteria while ensuring explainable, auditable outputs. You will collaborate with AI/ML teams to balance rules-based and model-assisted approaches, drive adoption, and align

Qualifications

Experience with payer claims data and clinical grouper concepts.
Translate complex payer/clinical/operational needs into BRDs, user stories, and validation docs.
Understanding of cost-of-care analytics, utilization benchmarking, and value-based care is a plus.

Responsibilities

Lead discovery workshops with payer stakeholders across business, clinical, actuarial, analytics and technology.
Document current-state claims classification workflows and data inputs/outputs.
Define data requirements and validation criteria for inpatient, outpatient, professional, and pharmacy claims.
Ensure traceability, explainability, and auditable outputs for compensation and reporting.
Partner with technical teams on data mappings, interfaces, and quality rules.
Support migration readiness, UAT planning, and production transition.
Collaborate with AI/ML teams to identify deterministic vs. ML-enabled enhancements.
Align governance for code sets, service categories, and business rules.
Drive adoption readiness and stakeholder communications with client owners.