Alignment Health · 13 hours ago
Technical Product Manager – Provider Solutions
United States
Full-time
Remote
Senior Level
$113K/yr - $170K/yr
5+ years expAlignment Health is a company dedicated to transforming healthcare for seniors and those with chronic illnesses. They are seeking a Technical Product Manager to merge product management and healthcare expertise, driving the strategy and delivery of software solutions for Medicare providers.
Health CareHospitalMedicalMedical DeviceWellness
Responsibilities
Drive the functional and technical roadmap for Provider Solutions on Alignment’s AVA and Claims platforms, ensuring alignment with Medicare business priorities, CMS requirements, and enterprise technology goals
Anticipate regulatory and operational changes (e.g., CMS rule updates, encounter data submission requirements) and integrate them into the roadmap
Lead the design, testing, and implementation of new features for Provider platforms
Oversee configuration of provider contracts, capitation and claims payment rules
Define requirements for interface integration between platforms, APIs, and EDI X12 transactions (837, 835, 277, 999) to support claims adjudication, payment, and provider portals
Translate CMS regulations and Medicare operational requirements into actionable business and system requirements
Partner with vendors to manage technical solutions and integrations, ensuring compliance with service-level agreements (SLAs)
Monitor end-to-end Provider workflows, starting with credentialing, network adequacy and contracting through provider setup, directory accuracy and payment automation and efficiency
Serve as the functional-technical bridge between DTS, Business Operations and network/provider engagement teams
Qualification
Required
5+ years of Product Management or Business Analyst experience in healthcare payer systems, with at least 3 years focused on TriZetto Facets
Strong functional expertise in Provider contracting, capitation arrangements, claims and payment reimbursement
Proven hands-on expertise with Microsoft SQL (querying, optimization, reconciliation, audits)
Proven hands-on expertise with ETL Tools such as Microsoft SSIS and Azure Data Factory
Proven hands-on expertise with Job Scheduling tools such as Redwood, Tidal and Control-M
Proven hands-on expertise with Cloud Platforms (Azure/AWS)
Experience integrating vendor solutions
Solid understanding of what drives compliance in a Medicare environment
Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes
Bachelor's degree in Information Systems, Computer Science, Business, Healthcare Administration, or related field. 4 years additional experience may be considered in lieu of education
Deep understanding of Provider Credentialing, Contracting and Reimbursement Strategies in a Medicare environment
Proficiency in relevant technical tools, such as SQL, Azure Data Factory, Jira, and Confluence
Experience in defining product strategies, managing product backlogs, and working within agile development methodologies
Familiarity with EDI standards and file protocols (HIPAA 837/835/820, XML, PDF fulfillment)
Vendor management and SLA performance oversight
Preferred
MBA or advanced degree
Company
Alignment Health
Alignment Health provides eldercare services.
501-1000 employees
H1B Sponsorship
Alignment Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (17)
2022 (13)
2021 (11)
2020 (6)
Funding
Current Stage
Public CompanyTotal Funding
$696.05MKey Investors
K2 HealthVenturesWarburg PincusGeneral Atlantic
2024-11-15Post Ipo Debt· $321.05M
2024-01-09Private Equity
2021-03-26IPO
Leadership Team
Dawn Maroney
President, Markets & CEO of Alignment Health Plan
John Kao
CEO and Founder
Recent News
Alignment Healthcare USA, LLC
2025-10-31
Company data provided by crunchbase