Marketplace Category Manager, Medical Payment Optimization

The Role

MacroHealth operates a two-sided healthcare marketplace connecting healthcare buyers with health market partners to improve the cost, quality, and access of healthcare. Our marketplace spans categories of healthcare spend, including Pharmacy, Medical Payment Optimization, and emerging opportunities, where buyers and health market partners come together to discover, evaluate, and transact around solutions to complex healthcare challenges.

The Marketplace Category Manager, Medical Payment Optimization is responsible for the strategy, development, and performance of MacroHealth's Medical Payment Optimization category, encompassing Out-of-Network (OON), Out-of-Area (OOA), Payment Integrity, No Surprises Act (NSA), and adjacent opportunities.

This leader develops deep expertise in medical claims economics, provider networks, reimbursement models, payment accuracy, regulatory dynamics, buyer needs, and health market partner capabilities to identify opportunities for differentiated, scalable value creation.

This is broader than traditional product management. The Category Manager serves as the strategic steward of the category, understanding where value is created or lost, where unmet demand or differentiated supply presents opportunity, and which interventions can improve marketplace performance.

Reporting to the Vice President, Marketplace Categories, this role works across Product, Marketplace Experience, Engineering, Data, Growth, and Customer teams to translate category strategy into measurable outcomes. Success is defined not by features delivered, but by the health, growth, differentiation, and economic performance of the Medical Payment Optimization marketplace.

What You'll Own

Category Strategy & Performance

• Develop and evolve the Medical Payment Optimization category strategy, including target markets, buyer problems, value proposition, differentiation, and growth opportunities across OON, OOA, Payment Integrity, and NSA.

• Maintain a deep understanding of medical claims economics, provider reimbursement, network arrangements, competitive dynamics, regulatory developments, and emerging payment models.

• Establish and monitor category performance measures across demand, supply, participation, transactions, customer outcomes, and economics.

• Translate marketplace insights into strategic priorities, investment recommendations, and opportunities to improve category performance.

Buyer Demand & Partner Ecosystem

• Deeply understand healthcare buyer needs, economics, workflows, purchasing behavior, and decision-making related to medical spend and payment optimization.

• Develop comprehensive knowledge of the solution landscape and the capabilities, incentives, and economics of existing and potential health market partners, including network solutions, repricing, payment integrity, and payment dispute resolution.

• Identify unmet buyer demand, gaps in marketplace supply, and opportunities to strengthen or diversify the partner ecosystem.

• Evaluate where friction across network access, pricing, claims adjudication, payment accuracy, and dispute resolution prevents buyers and partners from realizing value.

Marketplace Development & Discovery

• Identify and validate opportunities to expand, differentiate, and improve the Medical Payment Optimization marketplace through evidence-based discovery.

• Use customer insights, marketplace data, market research, regulatory developments, and healthcare economics to distinguish recurring market needs from individual customer requests.

• Evaluate potential interventions, including product capabilities, AI and data solutions, marketplace mechanisms, partner strategies, commercial models, and operational improvements.

• Develop hypotheses, business cases, and investment recommendations, advancing opportunities based on evidence of customer value, differentiation, regulatory feasibility, and economic potential.

Product & Marketplace Capabilities

• Translate category strategy and validated opportunities into clear marketplace capability needs and priorities.

• Partner with Marketplace Experience, Engineering, Design, Data, and AI to develop scalable solutions, distinguishing category-specific needs from reusable horizontal capabilities.

• Identify opportunities to improve solution discovery, matching, pricing intelligence, payment accuracy, workflow efficiency, and marketplace transparency through technology and automation.

• Define expected outcomes and evaluate whether investments deliver meaningful marketplace value.

Cross-Functional Leadership

• Serve as the strategic connective leader for Medical Payment Optimization across Product, Growth, Marketplace, Customer, Finance, Compliance, and technology teams.

• Align stakeholders around category strategy, market opportunities, investment priorities, and expected outcomes.

• Partner with commercial and operational leaders to improve marketplace participation, transaction activity, activation, and value realization.

• Influence decisions and drive accountability for category outcomes without relying on direct organizational authority.

How We'll Measure Success

• Category performance: Growth, revenue, pipeline, economic contribution, and customer value.

• Marketplace health: Quality and growth of buyer demand, differentiated supply, matching, participation, and transactions.

• Customer and partner outcomes: Medical cost savings, payment accuracy, access, satisfaction, retention, and expansion.

• Marketplace efficiency: Reduced friction and improved time to activation, payment resolution, and value realization.

• Category development: Quality of opportunities identified, validated, and advanced into scalable investments.

• Product impact: Adoption and effectiveness of category capabilities, including improvements enabled by data, AI, and automation.

What You Bring

• Significant experience in healthcare technology, medical claims, payment integrity, provider networks, healthcare cost management, product management, marketplace strategy, or related fields.

• Strong understanding of medical claims economics, provider reimbursement, network contracting, and payer payment models, with meaningful familiarity across OON, OOA, Payment Integrity, and NSA.

• Experience working with healthcare payers, TPAs, provider networks, repricing organizations, payment integrity vendors, or adjacent healthcare solution providers.

• Strong marketplace orientation, including supply and demand dynamics, incentives, matching, and marketplace economics.

• Demonstrated ability to develop strategies, identify market opportunities, and translate insights into actionable priorities.

• Exceptional curiosity, customer empathy, analytical thinking, and product discovery judgment.

• Commercial and financial acumen, with the ability to connect market opportunities to measurable customer and enterprise value.

• Experience using qualitative and quantitative evidence to evaluate opportunities and inform investment decisions.

• Ability to think beyond individual features or workflows to broader markets, ecosystems, incentives, economics, and scalable opportunities.

• Strong cross-functional leadership and influence across Product, Engineering, Growth, Customer, Compliance, and external partners.

• Understanding of how AI, data, and automation can improve medical payment economics, accuracy, and marketplace experiences.

How You Lead

• Curiosity and empathy: You seek to understand underlying buyer and partner needs before defining solutions.

• Marketplace thinking: You see the interconnected dynamics of supply, demand, incentives, network economics, and payment processes.

• Strategic ownership: You develop informed points of view, make thoughtful tradeoffs, and take accountability for category outcomes.

• One Team: You collaborate with humility, transparency, and low ego across functions.

• Discovery and adaptability: You challenge assumptions, test hypotheses, and change direction when evidence warrants it.

• Execution: You translate strategy into action and focus on measurable results rather than activity or feature delivery.

Above all, you continually ask: Where is value trapped in medical payment economics, what prevents healthcare buyers and health market partners from connecting effectively, and how can MacroHealth create differentiated, scalable value by bringing them together?