Senior Product Director, Prior Authorization (Remote)

Product Strategy & Vision

Defining and owning the long-term product vision and roadmap for medical cost containment and authorization capabilities.
Aligning product strategy with enterprise affordability, quality, and growth goals.
Identifying market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization.

Product Development & Lifecycle Management

Leading the end-to-end product lifecycle from concept through launch, optimization, and sunset.
Translating clinical, operational, and regulatory requirements into clear product requirements and prioritization.
Partnering with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions.
Safeguarding products to support evidence-based medicine, medical policy, and evolving clinical guidelines.

Medical Cost Containment & Authorization

• Overseeing products supporting prior authorization, concurrent review, retrospective review, and specialty management.
  Driving innovation in automation, rules engines, AI-assisted review, and straight-through processing.
  Balancing cost containment objectives with access to care, provider experience, and member satisfaction.

Cross-Functional Leadership

• Collaborating with stakeholders across products to ensure integrity and regulatory adherence.
  Partnering with Leadership & Finance to quantify savings impact and ROI.
  Supporting Sales and Client Management with product positioning, differentiation, and client engagement.

Governance, Compliance & Quality

• Ensuring products comply with federal and state regulations (e.g., CMS, NCQA, URAC, state DOI requirements).
  Supporting audit readiness and accreditation standards related to utilization management.
  Establishing KPIs and governance models to monitor product performance, outcomes, and quality.

Team Leadership

• Building, mentoring, and leading high-performing product management teams.
  Fostering a culture of accountability, innovation, and continuous improvement.

Availity Culture & Benefits

• A certified “Great Place to Work”!
• Several Culture teams, a Young Professionals Group, and various engagement opportunities.
• Competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits, and a 401k match program.
• Unlimited PTO for salaried associates + 9 paid holidays.
• Reimbursement for gym memberships, participation in racing events, weight management programs, etc.
• Education reimbursement.
• Paid parental leave for both moms and dads, both birth parents and adoptive parents.
• Partnership with various organizations for community engagement.