EDI Technical Product Manager

Job not on LinkedIn

🔥 16 hours ago

🇺🇸 United States – Remote

💵 $94.1k - $164.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚒️ Technical Product Manager (TPM)

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Define and evolve the EDI product vision, strategy, and long-term roadmap • Create business cases, success metrics, and ROI analyses to guide prioritization and investment decisions • Monitor industry trends, CMS/state requirements, and interoperability standards including X12, APIs, and FHIR • Translate business, regulatory, and integration requirements into user stories and technical specifications • Define data mapping, validation business rules, error handling flows, and downstream integration points • Collaborate with architecture, engineering, QA, and DevOps on solution design, technical feasibility, and deployment • Own and prioritize the EDI product backlog • Drive sprint planning, feature readiness, and release coordination • Identify and remove impediments affecting engineering throughput or trading partner readiness • Align technical teams, trading partners, clearing houses, and internal business units • Lead discovery sessions, refinement cycles, data exchange walkthroughs, and post-implementation assessments • Improve partner usability and operational efficiency through system improvements, automation, and monitoring • Analyze transaction performance, defect trends, operational SLAs, and platform telemetry • Define and track KPIs/OKRs including transaction throughput, first-pass acceptance rate, error volume, partner onboarding speed, and system reliability • Drive continuous improvement in observability, error reconciliation, and data integrity • Maintain product documentation, functional requirements, user guides, and integration specifications • Contribute to technical standards, EDI governance frameworks, and onboarding, testing, and release best practices • Ensure solutions comply with HIPAA, state Medicaid requirements, data privacy standards, and CareSource security guidelines • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree in computer science or related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Five (5) years of experience in product management or related field required • Strong understanding of EDI technologies and integration platforms • Familiarity with Agile methodologies and product development life cycles • Skilled in software development or engineering • Understanding of the healthcare industry and ecosystem, including future direction • In-depth knowledge of interoperability standards relevant to the industry • Strong verbal and written communication skills • Strong analytical and problem-solving skills • Ability to adapt to rapidly changing technologies and market conditions • Innovation mindset focused on enhancing capabilities and interoperability • Knowledge of AI technologies, machine learning models, and ethical considerations in AI deployment • Certifications in core technical systems such as Edifecs, Facets, Cloud, AI, or similar enterprise systems are preferred • Certifications in Agile, SAFE, or Business or Product Owner roles are preferred

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support