Description:
The Group Health Product Owner serves as the subject matter expert for Prime Health's Commercial Group Health solutions. Reporting to the Director of Product, this role is responsible for translating product priorities and business needs into clear, actionable work for Engineering and supporting the successful delivery of enhancements, features, and product improvements. This role requires expertise in Commercial Group Health claim processing, including the No Surprises Act, ERISA-related claim considerations, Qualifying Payment Amounts, claim scrubbing, large dollar negotiations, PPO network workflows, and out-of-network cost containment solutions.What You'll DoServe as the product subject matter expert for assigned Group Health solutions and product functionalityTranslate business needs, client requests, and operational workflows into clear product requirementsSupport claim-related solutions involving PPO networks, out-of-network claims, claim scrubbing, large dollar claim review, No Surprises Act, ERISA, and Qualifying Payment Amount conceptsProvide day-to-day product clarification and decision support during developmentPartner with Product Analysts, Engineering, QA, and the Agile Delivery Manager to support sprint readiness and delivery executionSupport user acceptance testing, validation, product demos, training, and stakeholder walkthroughsServe as a product resource for internal teams when questions arise about Group Health solutions, functionality, or client-specific needsSupport Implementation and Client Services through product knowledge transfer and workflow clarificationHelp identify product improvement opportunities based on feedback from clients, prospects, and internal stakeholders
Requirements:
What We're Looking ForBachelor's degree in Business, Healthcare Administration, Information Systems, Product Management, or a related field preferred5+ years of experience in a Product Owner, Product Analyst, Business Analyst, Operations, Claims, Network, or healthcare technology roleExperience in Commercial Group Health, healthcare claims, PPO networks, out-of-network solutions, medical bill review, claim repricing, or cost containment strongly preferredExperience with No Surprises Act, ERISA, Qualifying Payment Amounts, claim scrubbing, large dollar negotiations, PPO network application, or out-of-network claim handling preferredCompetenciesAbility to translate business needs and workflow requirements into clear functional requirementsExperience working with cross-functional teams in an agile delivery environmentStrong communication, collaboration, and problem-solving skillsAbility to clarify requirements and provide timely product direction during active development cyclesStrong attention to detail and ability to manage multiple prioritiesFamiliarity with backlog management tools such as Azure DevOps, Jira, or similar platforms preferredWhy You'll Love Working at Prime Health ServicesMedical Insurance (high deductible plan with an HSA)Dental InsuranceVision InsuranceShort-term and long-term disability paid by the companyGroup term life paid by the companyGenerous PTOWellness program with monetary rewardsEmployee recognition programs with monetary rewardsCorporate office amenities - specialty coffee machines, assorted tea options, smoothie bar, collaborative workspaces, fruit provide by company and an onsite marketRegular employee eventsAbout Prime Health ServicesPrime Health Services (PHS) is a national medical cost containment company specializing in customized PPO network solutions. Since 2001, we've partnered with insurance carriers, TPAs, self-insured groups, and government entities to deliver high-quality healthcare access at discounted rates. Our technology driven approach allows us to provide fast, flexible, and dependable service to our clients while supporting a collaborative, employee-focused workplace.PIfbc3f0-
