[Remote] Sr. Product Manager- Payment Integrity

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

Note: The job is a remote job and is open to candidates in USA. Codoxo is the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud, waste, and abuse. As Sr. Product Manager-Payment Integrity, you’ll be responsible for managing Payment Integrity products, driving the strategy and execution for the product suite while collaborating with various teams to deliver scalable solutions.

Own the product roadmap for Data Mining and Complex Claim Audit management products
Lead customer discovery with health plan audit teams, claims operations leaders, and clinical reviewers - going beyond surface-level requests to uncover generalizable workflow needs
Define product requirements across audit types (e.g., DRG validation, clinical validation, itemized bill review, data mining concepts), identifying common platform patterns while accounting for audit-type-specific logic
Shape the GenAI-powered medical record review experience, making critical product decisions about what to automate, where human judgment is essential, and how to design auditor-in-the-loop workflows
Collaborate with engineering and data science teams to deliver high-quality products, providing the domain context they need to build effectively
Partner with clinical SMEs and auditors to validate requirements, test assumptions, and ensure domain accuracy
Drive go-to-market readiness working with sales, marketing, and implementation teams on positioning, enablement, and launch
Make principled trade-off decisions - resisting one-off customization requests in favor of scalable, configurable product solutions that serve the broader market
Manage the Codoxo Payment Integrity products and ensure they meet the defined success metrics
Work closely with Codoxo data science, product engineering, customers, customer success, and Codoxo payment integrity experts to define and execute the roadmap for payment integrity products
Support product marketing to create content for internal and external stakeholders

Bachelor's in Engineering, Computer Science, technical related field, or equivalent practical experience
5+ years of professional experience in payment integrity, claims auditing, or claims operations - as a product manager, auditor, audit manager, solutions architect, or operations leader
3+ years in a Product Management role at a B2B SaaS or healthcare technology company, with direct ownership of roadmap, backlog, and delivery working alongside engineering teams
Working knowledge of multiple audit types with an understanding of how claims are identified for audit, how medical records are reviewed, and how findings are documented and recovered
Experience building or contributing to products that scale - you can point to examples where you turned domain-specific knowledge into configurable, platform-level product capabilities rather than customer-specific features
Comfort working with AI/ML-powered products - you don't need to be a data scientist, but you can reason about automation vs. human review trade-offs, provide feedback on model outputs, and design workflows where AI and human expertise complement each other
Strong customer discovery and stakeholder management skills - you can lead a conversation with a VP of Payment Integrity and an audit nurse with equal confidence, and translate what you learn into clear product direction
Proven experience in gathering and prioritizing product requirements into a meaningful product roadmap
Experience with Agile software methods
A learning and growth mindset with an ability to self-start on problems, a willingness to own problems, and a desire to make things better
You must demonstrate a strong product sense and have experience working with design teams
You can lead without giving orders and argue a viewpoint persuasively
You can write, speak, and think about complicated and highly technical problems with lucidity
Physical Requirements: Work is performed in an office environment (either in our office or work-from home) and requires the ability to work on a computer, operate standard office equipment, and work at a desk
Prior hands-on operational experience in claims or auditing before transitioning to a product or technology role - former auditors, audit team leads, or claims operations managers who moved into product bring invaluable workflow intuition
Experience managing products at different lifecycle stages simultaneously - maintaining and growing a mature product while launching a new one
Familiarity with clinical documentation, medical coding, and classification systems (ICD-10, CPT, DRG grouping, medical record abstraction)
Understanding of health plan IT ecosystems - claims adjudication platforms, EDI transactions (835/837), provider data, and how audit workflows integrate with core administrative systems
Experience working directly with data science or machine learning engineering teams on products that involve model-generated outputs reviewed by human users
Prior experience with analytics, healthcare payment integrity or revenue cycle management products is a plus
Proven record of product management accomplishments with demonstrated market success

Health, Dental, and Vision insurance with 100% employee premium coverage (Starts Day 1)
Unlimited PTO
Annual Professional Development stipend
Annual home office stipend
401K Match (after 90 days)

Codoxo leverages advanced generative and self-learning AI to enhance payment integrity in healthcare. It was founded in 2017, and is headquartered in Duluth, Georgia, USA, with a workforce of 51-200 employees. Its website is https://www.codoxo.com.

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