About the role
Position Purpose: Own the product strategy, roadmap, and end-to-end delivery for Payment Integrity platforms, including PISCES (Payment Integrity Systematic Code Editor Suite) pre-pay claim editing and Appeals/PI Bot automation. Translate Mission Simplify and Payment Integrity business priorities into execution-ready plans, requirements, and backlogs, using AI to improve speed, accuracy, and business outcomes.
* Develop, maintain, and publish the product strategy and multi-year roadmap for PISCES and Appeals/PI Automation capabilities, aligned to Payment Integrity, Mission Simplify, and BTS strategic priorities. * Lead strategic initiatives from intake and discovery through planning and delivery, owning BRDs, capability/feature hierarchy, and delivery-ready Jira backlogs. * Partner with Payment Integrity Operations, Engineering, Architecture, Project Management, and vendors to define scope, sequencing, dependencies, and success measures. * Drive PI Planning, prioritization, and predictable feature delivery; proactively communicate risks, trade-offs, and decisions to leadership. * Measure and report value realization, including savings, edit accuracy, automation rates, fallout, and cycle time. * Apply AI tools (e.g., Microsoft Copilot, Windsurf, Jira Rovo) across discovery, requirements, documentation, and analysis, and champion responsible AI with human-in-the-loop controls. * Measure the performance of a defined Domain space to assess efficiencies gained, value realized and ROI of product investments. * Partner with Payment Integrity Operations, Engineering, Architecture, Project Management, and vendors to define scope, sequencing, dependencies, and success measures. * Arbitrate portfolio impacts and delivery commitments for new or modified priorities. * Reviews and influences user stories and milestones to guide Agile and Scrum teams to deliver consistently and inline with product roadmaps. * Performs other duties as assigned. * Complies with all policies and standards.
Education/Experience: Requires a Bachelor's degree and 4 – 6 years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Preferred Skills
* 5+ years of product management, product ownership, or related technology experience in a healthcare payer or claims environment (7+ years preferred). * Payment Integrity, claims editing, appeals, or automation experience strongly preferred. * Experience with Agile/SAFe delivery and applying AI tools to product work preferred. Expereince with AI tools such as Microsoft Copilot, Windsurf/Devin Desktop, & Jira Rovo
Pay Range: $102,900.00 - $190,500.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Originally posted on Himalayas