Vice President, Product – Medical Cost Containment & Authorization

Responsibilities

Lead the strategy, execution, and scale of the Utilization Management (UM) product portfolio. Own an end-to-end product suite incorporating AI-driven decisioning and healthcare interoperability. Define and own the long‑term product vision and roadmap for medical cost containment and authorization capabilities. Align product strategy with enterprise affordability, quality, and growth goals. Identify market trends and regulatory changes impacting utilization management and authorization. Lead the end‑to‑end product lifecycle from concept through launch, optimization, and sunset. Ensure products support evidence-based medicine and evolving clinical guidelines. Build, mentor, and lead high‑performing product management teams.

Requirements

Bachelor’s degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred. 10+ years of experience 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 strategies. Strong understanding of managed care, payer operations, and healthcare regulations. Experience working with clinical teams and medical policy development. Background in digital health, automation, or AI-enabled clinical workflows. Proven success launching complex, regulated healthcare products at scale. Strategic product leadership and executive-level communication. Ability to translate clinical and regulatory complexity into usable products. Strong analytical and financial acumen. Collaborative leadership across clinical, technical, and business teams. Comfort operating in highly regulated, fast-changing environments.

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