This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Contract Modeling Product Owner based in United States.
This role leads the design and delivery of a next-generation healthcare contract modeling platform that turns complex payer agreements into scalable business rules and product functionality. You will bridge healthcare reimbursement expertise with product strategy and software development, translating contractual requirements into clear, actionable specifications. The position offers significant ownership across product roadmaps, requirements gathering, backlog prioritization, reimbursement logic, and delivery. You will work closely with reimbursement specialists, engineers, architects, QA teams, and external development partners to create reliable technology solutions. The role also contributes to AI-powered contract extraction and automation, helping establish robust validation and governance processes. This is an opportunity to shape capabilities that can improve contract compliance, underpayment detection, revenue forecasting, scenario modeling, and strategic pricing.
Accountabilities:
- Lead the definition and delivery of the healthcare contract modeling platform roadmap, product requirements, and prioritized backlog.
- Translate complex commercial payer contract language into detailed business rules, user stories, acceptance criteria, and technical specifications.
- Design, review, and validate reimbursement modeling logic covering DRG, APC, per diem, case rate, stop-loss, outlier, and other payment methodologies.
- Partner with software engineers, architects, QA teams, and external development partners to translate requirements into scalable, high-quality product functionality.
- Collaborate with reimbursement subject matter experts and product leadership to ensure modeling logic accurately reflects contractual and financial requirements.
- Support AI-powered contract extraction and automation initiatives by validating contract interpretation and establishing effective review and governance processes.
- Gather customer and market requirements to identify opportunities for future product capabilities and enhancements.
- Help shape functionality related to underpayment detection, contract compliance, scenario modeling, revenue forecasting, and strategic pricing.
- Support product delivery through effective requirements management, backlog prioritization, cross-functional communication, and validation of delivered functionality.
Requirements:
- 5+ years of experience in healthcare reimbursement, managed care contracting, revenue cycle management, contract management, or a closely related field.
- Bachelor's degree in Healthcare Administration, Business, Finance, Information Systems, or a related discipline.
- Deep expertise interpreting commercial payer contracts and reimbursement models, including DRG, APC, per diem, and case-rate methodologies.
- Experience gathering business requirements and partnering with software development teams to deliver technology solutions.
- Strong understanding of healthcare financial data, claims adjudication, reimbursement analytics, and related financial processes.
- Ability to translate complex contractual and reimbursement concepts into clear business rules and product requirements.
- Strong communication and collaboration skills, with the ability to work effectively across clinical/financial subject matter experts, product teams, engineering, QA, and external partners.
- Experience with product ownership, contract modeling platforms, Agile development methodologies, and/or AI-driven document automation is preferred.
- Strong analytical and problem-solving skills with attention to detail and the ability to manage complex requirements.
- Must be legally authorized to work in the United States.
- This position is not eligible for employment visa sponsorship now or in the future.
Benefits:
- Remote work opportunity.
- Opportunity to lead the development of technology supporting complex healthcare reimbursement and contract modeling.
- Significant ownership across product strategy, roadmap development, requirements, backlog prioritization, and delivery.
- Exposure to AI-powered contract extraction and automation initiatives.
- Opportunity to collaborate with cross-functional teams spanning healthcare reimbursement, product, engineering, architecture, QA, and customer requirements.
- Opportunity to contribute to capabilities focused on contract compliance, underpayment detection, revenue forecasting, scenario modeling, and strategic pricing.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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