CLINICAL PRODUCT OWNER (PRIOR AUTHORIZATIONS SME)

CLINICAL PRODUCT OWNER (PRIOR AUTHORIZATIONS SME) COMPANY OVERVIEWGlint Tech Solutions is a women-owned global staffing and IT recruiting firm dedicated to connecting exceptional talent with industry-leading opportunities across the US and beyond. We partner with top-tier clients across healthcare, technology, finance, and logistics to place high-caliber professionals in roles that truly make an impact.PROJECT DESCRIPTIONOur client is seeking a highly experienced Clinical Product Owner and Business Integration Lead with deep expertise in clinical prior authorizations to drive a complex, cross-functional initiative focused on the complete analysis and potential redesign of the prior authorization process. This is a lead-level, fully remote position requiring a true SME in Prior Authorizations, FACETS, 278 transactions, and Claims Processing. The ideal candidate brings 15+ years in healthcare and payer operations, with the last 8+ years in a Clinical Product Manager capacity. Day-to-day responsibilities include engaging clinical, business, and IT stakeholders to analyze current PA workflows, identify pain points, and drive meaningful process improvements.KEY RESPONSIBILITIESLead cross-functional meetings with clinical, business, and IT stakeholders to analyze current prior authorization processesIdentify pain points and drive resolutions to improve PA workflows end-to-endSupport complete analysis and potential redesign of the client's prior authorization processServe as primary SME for Clinical Prior Authorizations, FACETS, 278 transactions, and Claims ProcessingDeliver executive-level reporting and manage complex, multi-stakeholder initiativesTranslate clinical and business requirements into actionable product and integration strategiesMANDATORY SKILLS15+ years in healthcare delivery, payer operations, UM, or PA programsLast 8+ years as a Clinical Product Manager or Business Integration LeadEnd-to-end knowledge of Clinical Prior Authorizations — critically importantFACETS expertiseClaims processing knowledge278 transaction experienceBasic working knowledge of GuidingCareExcellent communication, stakeholder management, and executive-level reporting skillsMust be US-basedNICE-TO-HAVE SKILLSExperience leading prior authorization process redesign initiativesBackground working with large healthcare payers or managed care organizationsFamiliarity with UM/PA regulatory and compliance frameworksOriginally posted on Himalayas