Vice President, Product, Medical Cost Containment & Authorization
WFA Digital Insight
As the healthcare industry undergoes significant transformation, the demand for innovative product leaders has surged. With over 12 billion transactions processed annually, Availity is at the forefront of this change. The role of Vice President of Product, Medical Cost Containment & Authorization, requires a unique blend of strategic vision, technical expertise, and collaboration. Candidates with experience in AI-driven decisioning, healthcare interoperability, and deep UM expertise are in high demand. According to recent trends, the healthcare technology market is expected to grow by 25% in the next two years, driven by the need for efficient and effective solutions.
Job Description
About the Role
The Vice President of Product, Medical Cost Containment & Authorization, will lead the strategy, execution, and scale of Availity's Utilization Management (UM) product portfolio. This is a high-impact, executive-level role that requires a product leader who thrives in ambiguity, can operate as a peer to senior executives, and has the confidence to lead through scale, complexity, and change. The successful candidate will have a deep understanding of the healthcare industry, including managed care, payer operations, and healthcare regulations.The role entails defining and owning the long-term product vision and roadmap for medical cost containment and authorization capabilities. This includes aligning product strategy with enterprise affordability, quality, and growth goals, identifying market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization.
As part of the Availity team, the Vice President of Product will collaborate with cross-functional teams, including clinical, technical, and business stakeholders, to drive innovation and growth. The company values innovation and collaboration, positioning Availity as a leader in interoperability and burden reduction.
What You Will Do
- Define and own the long-term product vision and roadmap for medical cost containment and authorization capabilities
- Align product strategy with enterprise affordability, quality, and growth goals
- Identify market trends, regulatory changes, and competitive opportunities impacting utilization management and authorization
- Develop and execute a comprehensive product plan, including AI-driven decisioning, healthcare interoperability, and deep UM expertise
- Collaborate with cross-functional teams, including clinical, technical, and business stakeholders
- Provide strategic product leadership and executive-level communication
- Translate clinical and regulatory complexity into usable products
- Analyze market trends and competitor activity to inform product decisions
- Develop and manage budgets, forecasts, and resource allocation plans
- Foster a culture of innovation, accountability, and continuous improvement
What We Are Looking For
- Bachelor's degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred
- 10+ years of experience in healthcare product management, medical management, or utilization management
- 5+ years in a senior product leadership role
- Deep expertise in prior authorization, utilization review, and medical cost containment strategies
- Strong understanding of managed care, payer operations, and healthcare regulations
- Experience working with clinical teams and medical policy development
- Background in digital health, automation, or AI-enabled clinical workflows
- Proven success launching complex, regulated healthcare products at scale
- Strategic product leadership and executive-level communication
- Ability to translate clinical and regulatory complexity into usable products
- Strong analytical and financial acumen
Nice to Have
- Experience with AI-driven decisioning and machine learning algorithms
- Knowledge of healthcare interoperability standards and protocols
- Familiarity with cloud-based technologies and agile development methodologies
- Certification in healthcare management or a related field
Benefits and Perks
- Competitive salary and bonus structure
- Comprehensive health, dental, and vision insurance
- 401(k) retirement plan with company match
- Flexible paid time off and remote work arrangements
- Professional development opportunities and education assistance
- Access to cutting-edge technologies and innovative products
- Collaborative and dynamic work environment
How to Stand Out
- Develop a strong understanding of the healthcare industry, including managed care, payer operations, and healthcare regulations.
- Showcase your experience with AI-driven decisioning, healthcare interoperability, and deep UM expertise in your portfolio.
- Highlight your ability to translate clinical and regulatory complexity into usable products.
- Prepare to discuss your experience with cross-functional teams, including clinical, technical, and business stakeholders.
- Research Availity's products and services to demonstrate your knowledge and interest in the company.
- Be prepared to provide specific examples of your experience launching complex, regulated healthcare products at scale.
- Consider obtaining certifications in healthcare management or related fields to enhance your application.
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