Product Owner - Claims

Work Location: This position is designated as remote. However, employees who reside within a 40-mile radius of one of our office locations in Tampa, FL; Canonsburg, PA; or Bowie, MD will follow a hybrid work schedule and are expected to work in the office two days per week (Tuesdays and Wednesdays).

Overview: The Product Owner is responsible for establishing a deep product expertise both from a technical and market perspective by understanding buyer and user personas, value proposition, benefits, features and functionality, competitive landscape, architecture, code base, and technical components. This person collaborates closely with other product owners, product managers, scrum master(s), and development managers to leverage Agile processes and tools which support product requirements, sprint review, backlog refinement (grooming), sprint planning, retrospectives, and backlog/ticket creation. This role will partner closely with product managers in reviewing product roadmaps and drive the prioritization of work accordingly. The Product Owner will partner closely with product managers in reviewing product roadmaps and drive prioritization of work accordingly. This role will plan, prioritize, and maintain product feature backlog and development for a product. This person has prior experience with software-as-a-service (SAAS) distribution models.

Duties and Responsibilities:

• Own feature enhancements within the Claims prioritized backlog, drive sprint planning, backlog refinement, reviews, and retrospectives in partnership with engineering.

• Drive end-to-end claims processing capabilities and automation across all payer types (Medicare, Medicaid, and commercial), ensuring compliance with HIPAA and ICD-10 standards; leverage industry-standard formats (837 UB/1500) and rules engines to achieve high first-pass rates and minimize denials.

• Lead integration of Electronic Data Interchange (EDI) transactions and revenue cycle workflows to streamline claim submission, ERA reconciliation, and secondary claim handling; partner with engineering and payer teams to optimize automation, reduce administrative burden, and accelerate reimbursement cycles.

• Adopt and role model Agile behaviors while building an inclusive team culture.

• Drive strong collaboration across internal stakeholders including product, engineering, corporate development, and marketing to ensure timely execution and delivery of our products to market.

• Engage with internal and external stakeholders to inform product and feature design to drive perspective, requirements, and prioritization of the backlog in line with the product vision and while communicating expectations to internal and external stakeholders.

• Develop detailed business requirements that meet the needs of internal and external stakeholders and support corporate objectives;

• Analyze the current system or application, conceptualize and define operational problems, model and present recommended enhancements and modifications, and walk each new enhancement or modification through the development process, from planning and preparation to testing and implementation;

• Oversee the design, prioritization, and delivery of products through the software development lifecycle, from concept to testing, deployment, adoption and value realization

• Perform validation and testing of solutions through managing and executing user acceptance plans, collaborating with the engineering team during user testing and complex validation sessions, and responding to technical and functional product questions raised by stakeholders, and reformulate solutions as necessary to ensure that the recommended solution is responsive to the data requirements;

• Analyze the impact of a proposed solution on connected processes, systems, and/or applications to determine the best course of action to achieve the desired outcome;

• Assist in the development of roadmaps and business strategy for assigned product or department;

• Demonstrate robust knowledge of the healthcare industry, product management, and software development to translate problems, needs, and opportunities into user stories.

• Display effective time management across complex and overlapping projects while supporting your team with schedule and priority management.

• Maintain compliance with Inovalon’s policies, procedures and mission statement;

• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; and

• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Employer.

Job Requirements:

• Minimum 3 years of experience with SAAS healthcare product ownership, business analysis, or product management roles with proven domain knowledge of claims workflows, EDI, and payer requirements.

• Agile / SCRUM experience and/or certification;

• Excellent interpersonal, written, and oral communication skills;

• High level of honesty, respect, dependability and flexibility;

• Experience in fast-paced and rapidly growing environment;

• Strong business acumen;

• Must be comfortable gathering feedback from internal and external stakeholders.

• Proficiency of Microsoft Office tools, including Word, Excel, and PowerPoint preferred; and

• Great organizational skills and ‘get things done’ attitude.

Education:

• Bachelor’s Degree or an equivalent combination of education and experience.

Physical Demands and Work Environment:

• Sedentary work (i.e., sitting for long periods of time);

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force;

• Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions;

• Subject to inside environmental conditions; and

• Travel for this position will include up to 10%.

This position is not eligible for immigration sponsorship (e.g. H-1B, TN, or E-3). Applicants must be authorized to work in the United States as a condition of employment. (This is only applicable for US-based positions)

If you don’t meet every qualification listed but are excited about our mission and the work described, we encourage you to apply. Inovalon is most interested in finding the best candidate for the job, and you may be just the right person for this or other roles.

By embracing inclusion, we enhance our work environment and drive business success. Inovalon strives to provide equal opportunities to the communities where we operate and to our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.

Inovalon is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.

To review the legal requirements, including all labor law posters, please visit this link

To review the California Consumer Privacy Statement: Disclosures for California Residents, please visit this link

Work Location: If the US position is listed as remote, employees who reside within a 40-mile radius of one of our office locations in Tampa, FL; Canonsburg, PA; or Bowie, MD will follow a hybrid work schedule and are expected to work in the office two days per week (Tuesdays and Wednesdays).