Director, Product Management — AI Claims Platform

Location: Remote / Hybrid East Coast preferred
Employment Type: Contract-to-Hire
Compensation: $200000$230000 USD base bonus RSUs

Our client is a major U.S. healthcare organization operating across healthcare and health insurance services.

They are seeking a Director of Product Management AI Claims Platform to lead a portfolio of AI-powered products supporting complex health insurance claims operations.

This is not a generic AI product role. The organization is developing a platform designed to help claims teams review claims more accurately and efficiently by using AI to understand policies claims data business rules and operational workflows and provide decision support around whether claims should be approved denied adjusted or escalated.

The platform is currently in an MVP / improvement phase and is not yet fully mature. The successful candidate will therefore need to be comfortable operating with ambiguity creating structure and evolving products and requirements as the platform develops.

The Director of Product Management will own the broader AI Claims Platform portfolio which includes:

• Decision-support tools
• Auto-adjudication support
• Claims advisor capabilities
• Knowledge-base functionality
• Policy understanding
• Rules-engine enhancements

This is both a strategic and hands-on product leadership role.

You will lead Product Managers while remaining directly involved in shaping product strategy roadmaps requirements and product logic. The ideal candidate can translate highly complex healthcare policies and operational workflows into technology products rather than operating solely as a people manager or high-level strategist.

• Own product strategy and roadmap development across the AI Claims Platform portfolio.
• Translate complex healthcare policies business rules and operational workflows into product logic and requirements.
• Help shape products from the MVP stage through continued improvement and maturity.
• Work hands-on with requirements and product decisions while providing broader strategic direction.
• Establish structure and product processes in an evolving environment.

• Lead products involving AI/ML analytics automation and decision-support capabilities.
• Help develop and improve AI-powered recommendations supporting claims operations.
• Drive products involving complex rules-based workflows.
• Partner with technical teams on AI-enabled product development.
• Support products involving human-in-the-loop decision making and operational AI.

The emphasis is on decision support and real operational product ownership rather than simply GenAI strategy or experimentation.

• Partner closely with claims and healthcare operations stakeholders.
• Understand complex claims workflows policies and business rules.
• Translate operational requirements into scalable product capabilities.
• Build credibility with payer and claims stakeholders through a strong understanding of healthcare operations.

Relevant areas may include:

• Claims adjudication / auto-adjudication
• Payment integrity
• Prior authorization
• Utilization management
• Provider operations
• Member servicing
• Claims workflow automation
• Rules engines and decision engines

• Manage an existing team of 2 Product Managers.
• Potentially help grow the team by approximately 2 additional Product Managers.
• Coach and develop PM talent while remaining actively involved in product ownership.
• Help shape the product roadmap and requirements rather than functioning solely as a people manager.

Partner closely across:

• Business
• Operations
• Data Science
• Engineering
• Claims subject-matter experts

The successful candidate will need strong executive communication and stakeholder-management skills and the ability to operate effectively within a complex cross-functional organization.

• Director Principal Product Manager Group Product Manager Lead Director or comparable senior product leadership experience.
• Demonstrated decision-support or workflow-automation product experience.
• Experience within payer claims health insurance or another highly complex policy/rules-based workflow environment.
• Demonstrated ability to translate policies and business rules into product logic.
• Strong executive communication and stakeholder-management capabilities.
• Cross-functional experience partnering with Data Science Engineering Operations and Business teams.
• Comfortable working in an MVP-stage environment with ambiguity and building structure.
• Product experience involving AI/ML GenAI LLMs human-in-the-loop systems analytics or automation.
• Genuine product ownership including roadmap and product development responsibility.

Experience in one or more of the following is highly desirable:

• Claims adjudication or auto-adjudication
• Rules engines or decision engines
• Payer / health insurance operations
• Prior authorization
• Payment integrity
• Provider/member claims
• Utilization management
• Managing Product Managers or product squads
• Building product operating models
• AI governance evaluation auditability or human oversight
• Consulting experience within payer or healthcare operations

A strong management consulting background is particularly valuable when combined with payer experience involving claims digital transformation AI/analytics automation product strategy or operations transformation.

Were looking for someone who:

• Has personally owned and shipped products.
• Can translate complicated healthcare policies and workflows into product logic.
• Understands decision-support and workflow automation.
• Can work effectively with healthcare operations stakeholders.
• Can operate strategically while remaining hands-on with the product.
• Has experience working across business operations Data Science and Engineering.
• Is comfortable creating structure in an evolving MVP-stage environment.
• Can lead Product Managers without becoming removed from day-to-day product ownership.

Candidates whose experience is primarily BI/dashboard product management high-level GenAI strategy without shipped products transformation/program management without roadmap ownership or healthcare without AI/automation/product ownership would not align closely with the requirements.

• Base Salary: $200000$230000 USD
• Bonus
• RSUs
• Contract-to-hire opportunity
• Remote / hybrid work model
• East Coast candidates preferred

• Own a high-visibility AI product portfolio focused on transforming complex healthcare claims operations.
• Lead products spanning decision support auto-adjudication policy understanding knowledge management and rules-engine capabilities.
• Join at the MVP/improvement stage and have meaningful influence over how the platform evolves.
• Lead and grow a Product Management team while remaining directly involved in product strategy and execution.
• Work at the intersection of healthcare operations AI Data Science Engineering and Product.

If you have experience owning complex AI automation decision-support or healthcare technology products and enjoy translating complicated policies and operational workflows into scalable product solutions wed love to hear from you.

• $200000$230000 USD base
• Bonus RSUs
• Contract-to-hire
• Remote / hybrid
• East Coast candidates preferred
• Leadership of an existing Product Management team with expected growth