Claims Benefit Configuration Product Manager / Specialist

Business woman talking to a client

Full-time; US office

Company

HighRoads is the industry leader in sales-enabling health plan product management. Our cloud-based technology empowers our health plan clients to quickly configure and sell innovative compliant products that meet customer needs and differentiate them from the competition.

Position Summary/Scope

HighRoads is hiring for a Claims Benefit Configuration Product Manager / Specialist that will report into Product Management. In this role, he/she will be the primary subject matter expert (SME) on the Claims systems’ benefit configuration functional and technical details and how they relate to the HighRoads’ solution. The Claims Benefit Configuration Product Manager / Specialist will be responsible for ensuring the product adheres to the Claims system’s evolving capabilities and for identifying additional product capabilities to continuously enhance HighRoads’ Claims Benefit Configuration solution.

Responsibilities/Success Factors

Specifically, the Claims Benefit Configuration Product Manager / Specialist will be expected to:

  • Own the Claims Benefit Configuration product capability and serve as the organization’s subject matter expert (SME) on Benefit Mapping and Configuration in Claims systems including Facets, HealthEdge, QNXT, and NASCO.
  • Understand and interpret the relevant claims system and version requirements and ensure that the product adheres to those requirements.
  • Understand and contribute to the development of the product roadmap as it relates to expanding the Claims Benefit Configuration product capabilities based on market needs and drivers.
  • Write detailed functional specifications, for use by both technical and non-technical readers, that describe business transaction functionality and related use cases.
  • Develop content for product training material.
  • Participate in sales demos as a product SME for Benefit Configuration and Mapping in Claims systems.
  • Support UAT.

Ideal Qualifications

  • Previous experience working in the healthcare payer industry is required.
  • A minimum of 5 years of experience working in a role that requires a deep understanding of Facets plus one or more of QNXT, HealthEdge, and NASCO products. Experience with claims systems’ internal data structures and rules as it pertains to product installation and other related downstream needs.
  • Deep knowledge of the Facets version capabilities and the payer business processes associated with it.
  • Applied experience in Agile teams and applying continuous improvement practices.
  • Demonstrable experience building detailed functional specifications for use by both technical and non-technical readers.
  • Experience with cloud development and cloud infrastructures.
  • Understanding of web-oriented design best practices and principles. Strong interpersonal, problem solving and situation analysis skills.
  • Expert understanding of SaaS platform capabilities and partner tools.
  • Bachelor’s Degree in a technical/business discipline.

Ideal Personal Characteristics

  • A Focus on Execution. A self-starter with a bias for action. A non-political team player who can quickly establish himself/herself as a trusted member of the team and can be relied upon to get things done.
  • Company Focused. Someone who identifies closely with and is committed to the achievement of the Company’s mission while working in concert with other groups internally and externally.
  • Nimble in the Face of Ambiguity and Adversity. Grounded/pragmatic; someone who naturally adjusts to changing internal/external dynamics, priorities and challenges. Decisive optimist / “can-do” attitude; values people and focuses on “doing the right thing”.
  • Energetic and Optimistic. HighRoads is a dynamic, innovative company with a “can-do” culture. It wants team members who continue to build on this culture.
  • “Equity” Mindset. The successful candidate will have a proven ability to pursue his/her objectives passionately with an ownership mentality and a focus on the overall success of the Company.
  • Maturity and Independence. A highly ethical and intelligent professional who effectively represents the company and its mission internally and externally and who brings enhanced credibility to the firm and its products. A thoroughly honest and forthright individual who is up-front and direct with subordinates, peers and top management executives.

Location

Hiring in Burlington, MA / U.S. Remote

Questions? Please email careers@highroads.com

Ready to Apply? Please submit your resume and cover letter to careers@highroads.com

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