Expert Claims Review Product Owner

Position Overview

The Expert Claims Review Product Owner is a key member of the Price Optimization business unit, who should be able to operate within and help drive an Agile Scrum Team as well as being capable of leading & driving small to large scale initiatives outside of the Agile Scrum structure. This Product Owner will be working within the Expert Claims Review Product team and aligned with the Expert Claims Review operational team with a focus on Itemized Bill Review, Clinical Chart Review, and Document Retrieval for both pre-payment and post-payment products. This position will work in close partnership with Business Operations, Ideation, Sales, IT, and Implementation departments in the development and maintenance of the current product(s) as it relates to scalability, functionality, and initiatives imperative to growth. This position also oversees business processes including support for communication, documentation, and knowledge transfer for release and operational support readiness. Enhancements to operational efficiencies, technology advances and process improvements will be a key focus of this role.

What You’ll Do

• Contribute to the end-to-end Product Lifecyle Management for responsible Products.
• Maintain a deep understanding of the business needs and the factors driving the impact and priority.
• Support and analysis in ensuring data driven delivery of product roadmap; Return on Investment assessment, business impact analysis, goal alignment, operational impact analysis, etc.
• Translating these business needs into User Stories which the Agile team can understand and work from.
• Applying the concepts of Minimum Viable Product (MVP), to shape “what to work on next.” 
• Being able to take the initiative and make decisions, to keep the team moving forward

• Preparation and Participation in PI Planning: As a member of the extended Product Management team, the Product Owner is heavily involved in program backlog refinement and prep for Program Increment (PI) planning and plays a significant role in the planning event itself.
• Sprint Execution: Maintaining the team backlog – With input from System Architect/Engineering and other stakeholders, the Product Owner has the primary responsibility for building, editing, and maintaining the team backlog.
• Program Execution: During each PI, the Product Owner coordinates dependencies with other Product Owners. This often occurs in regularly scheduled Product Owners sync events. The Product Owners also has an instrumental role in ensuring the production of any system demos for stakeholder evaluation and review.
• Content Authority: SAFe leverages several artifacts such as Features, Stories, Non-Functional Requirements, design artifacts, and so forth, to guide the ART in creating the solution.
• Participate in relevant Agile ceremonies: Daily Stand-Ups, Backlog Grooming, Sprint Planning, Sprint Review, Sprint Retrospective.
• Assist with the elaboration of the user stories and requirements, supporting team members with their work where required.
• Be responsible for providing multi-disciplinary teams with user stories and coaching to define the business-driven acceptance criteria and test cases. Proactively support the uplift of Agile practices and foster a culture of continual service improvement.
• Consult with the business, business analysts and other product owners to prioritize and shape the product backlog, using Agile practices for prioritization around business value.
• Define, implement, and maintain business processes and procedures to meet business objectives. Analyze and identify opportunities for business process improvements.
• Collaborate with Solution Owners and/or other Product leaders when defining product release content and timeline, applying product development principles, innovative thinking and a focus around the customer or user experience.
• Critically evaluate information gathered from multiple sources, reconcile conflicts, and decompose high-level information into details.
• Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements.
• Create training materials and documentation for internal and/or external applications.
• Perform a thorough gap analysis of existing to potential functionality for internal and/or external applications.
• Perform analysis and identify gaps in functionality for system integrations.
• Collaborate with the Scrum team to establish the technical vision and analyze tradeoffs between usability and performance needs.
• Improves systems by studying current practices, designing modifications.
• Assist in Quality Assurance (QA) and/or User Acceptance Testing (UAT) of new software or enhancements to existing software as needed.
• The ability to multi-task and work on multiple assignments will be required.
• This individual must also demonstrate clear and concise communication both verbally and in writing.
• Travel requirements to (primarily) domestic destinations should not exceed 10%.

What You’ll Bring to Zelis

• Disciplined, structured and logical approach to problem solving.
• 4+ years of experience with Business Analysis and/or Product Owner prior roles.
• Experience in Healthcare industry preferred.
• Knowledge of Payment Integrity solutions (hospital billing, claims editing, reimbursement methodologies and acceptable billing practices) preferred.
• Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards preferred.
• SQL experience preferred, however coding will not be required.
• The ability to learn a new business and translate these needs into new products, and perform high-level troubleshooting functionality.
• Strong troubleshooting, analytical, and business process development skills
• Experience in product development life cycle.
• Experience with writing business requirements, technical requirements, user stories, enabler stories, functional specifications, and/or quality assurance testing.
• Knowledge of SDLC methodologies including experience working in an Agile environment.
• Fluent with Microsoft Office Suite including Visio.
• Workflow diagram creation and wireframe creation.
• SAFe POPM, CPO, CSPO, Agilist, Teams, or Leading Safe certification preferred.
• Bachelors degree preferred.

Base Salary Range

$105,000.00 - $140,000.00

At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.

Zelis’ full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.