Technical Product Manager – Clinical Solutions

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October 16

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Alignment Health

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Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💰 $135M Series C on 2020-03

📋 Description

• Drive the functional and technical roadmap for Clinical Solutions, including Utilization, Care Management platforms, Clinical decision support systems, quality measures, and interoperability solutions leveraging Alignment’s proprietary AVA and Vendor platforms. • Ensure compliance with CMS, NCQA, HIPAA, and other regulatory requirements impacting clinical data and processes. • Anticipate regulatory and operational changes (e.g., CMS rule updates, encounter data submission requirements) and integrate them into the roadmap. • Lead the design, testing, and implementation of new features for Clinical solutions platforms. • Define and drive integration with Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and other clinical data platforms via APIs, HL7, FHIR, and batch interfaces. • Partner with data engineering teams to design solutions that support risk adjustment, HEDIS/Stars quality reporting, care gap closure, and population health analytics. • Define and prioritize features for provider-facing tools such as prior authorization, utilization management, case management, and clinical documentation improvements. • Collaborate with clinicians, business stakeholders, and technology teams to translate clinical workflows and requirements into scalable technical solutions.

🎯 Requirements

• 5+ years of Product Management experience in healthcare technology, with a focus on clinical solutions. • Advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred. • Proven hands-on expertise with: Healthcare interoperability standards (FHIR, HL7, X12, CCD, CDA) • Microsoft SQL (querying, optimization, reconciliation, audits) • ETL Tools such as Microsoft SSIS and Azure Data Factory • Cloud Platforms (Azure/AWS) • Experience integrating vendor solutions. • Strong knowledge of clinical workflows, care management, utilization management, and quality reporting. • Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes. • Bachelor's degree in Healthcare Information Systems, Computer Science or related field; advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred. MBA or advanced degree preferred.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work arrangements • Paid time off • Professional development opportunities