Consulting Manager, Product Owner - Healthcare Payer

About the Role

The Vendor shall provide personnel with the knowledge, skills, and experience necessary to perform the services described. Assigned resources must demonstrate proficiency in their roles and maintain appropriate qualifications throughout the engagement.

Responsibilities

• Participate in developing and/or modifying requirements, business design specifications, user training, and documentation.
• Test and document solutions.
• Serve as liaison between software users and technical staff.
• Conduct assessments of current processes, reports, and procedures.
• Collect data and perform quantitative analysis to substantiate assumptions.
• Perform ad hoc reporting as necessary.
• Measure outcomes of quality improvements using metrics and benchmarking criteria.
• Leverage healthcare claims experience, including workflow design, data analysis, and systems automation/testing.
• Perform configuration changes supporting claim holds.
• Generate or gather needed test data.
• Perform validation in test and production environments according to business requirements.
• Demonstrate analytical, problem-solving, and decision-making capabilities.
• Exhibit strong written and verbal communication skills for effective interaction with business and technical stakeholders.
• Collaborate across cross-functional teams.

Requirements

• Preferred experience in claims, provider, and pricing services.
• Preferred Safe Agile certifications or 3+ years of experience as a Product Owner.
• Preferred experience in Fusion and/or Streamline.
• Experience in QTest and JIRA.
• Experience in mainframe and PEGA systems.
• Experience supporting comparable projects or organizations.

Vendor Responsibilities

• Identify specific skills, certifications, experience levels, and responsibilities for each proposed resource.
• Ensure personnel possess qualifications commensurate with the complexity of the work.
• Maintain appropriate documentation and knowledge transfer practices to ensure continuity of services.
• Replace resources with personnel of substantially equivalent qualifications if needed.
• Maintain professional competency of assigned personnel, ensuring they remain current with technologies, industry practices, and regulatory requirements.