Principal Product Manager, Healthcare Payer Strategy

We are seeking a strategic Product Manager to help define and drive Oracle Health’s healthcare payer strategy in the United States.

In this role, you will serve as a market-facing product leader responsible for shaping the roadmap, positioning, and go-to-market strategy for Oracle’s healthcare payer solutions. You will work closely with healthcare payer executives, industry leaders, customers, sales teams, product organizations, and engineering teams to ensure our platform evolves to meet the changing needs of the U.S. healthcare market.

Unlike traditional product management roles focused primarily on feature delivery and detailed requirements, this position is focused on understanding market dynamics, identifying strategic opportunities, influencing portfolio direction, and helping prospective customers understand the value Oracle Health can deliver across their business.

The scope of this role spans multiple healthcare payer solution domains, including claims adjudication, prior authorization automation, interoperability, healthcare analytics, contract and benefit plan modeling, payment integrity, provider reimbursement, and value-based care automation. As healthcare organizations increasingly seek to reduce administrative burden and improve provider experiences, this role will help shape Oracle Health's strategy for modernizing and automating prior authorization workflows through intelligent, interoperable, and AI-enabled solutions. The successful candidate will help define how prior authorization capabilities integrate with claims processing, provider engagement, utilization management, and broader payer operations to deliver meaningful business value for customers.

This is an opportunity to play a key role in defining the future of Oracle’s healthcare payer platform and helping some of the largest healthcare organizations in the United States navigate an increasingly complex and rapidly evolving healthcare landscape.

U.S. citizenship is required for this position, as the successful candidate will be required to obtain and maintain a U.S. government security clearance after hire.

Required Qualifications

• Deep expertise in U.S. healthcare payer operations and business processes.
• Strong understanding of healthcare claims adjudication, provider reimbursement, benefit administration, payer analytics, interoperability, and value-based care programs.
• Strong understanding of healthcare utilization management, prior authorization workflows, and the operational interactions between authorization, claims adjudication, provider reimbursement, and medical management processes. 
• Experience working with healthcare payer operations related to utilization management, care management, prior authorization, claims administration, or provider operations.
• Experience in product management, healthcare consulting, payer operations leadership, healthcare technology strategy, or a related role.
• Demonstrated success developing product strategy, market strategy, or business transformation initiatives within healthcare payer organizations.
• Strong executive communication, presentation, and stakeholder management skills.
• Experience engaging with senior leaders and executive decision-makers within healthcare organizations.

Preferred Qualifications

• Experience working with commercial health plans, Blues plans, Medicare Advantage organizations, Medicaid managed care organizations, or government healthcare programs.
• Experience with prior authorization platforms, utilization management systems, care management solutions, or provider engagement technologies. 
• Knowledge of CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) and emerging industry standards supporting electronic prior authorization workflows.
• Knowledge of healthcare interoperability standards and regulatory programs, including FHIR and CMS interoperability requirements.
• Experience with healthcare analytics, population health, quality measurement, risk adjustment, payment integrity, and care management solutions.
• Knowledge of value-based payment models and reimbursement methodologies, including ACOs, bundled payments, shared savings arrangements, and capitation.
• Understanding of healthcare benefit configuration, contract modeling, network management, and provider reimbursement strategies.
• Demonstrated expertise in leveraging generative AI and advanced AI technologies to support market analysis, strategic planning, customer engagement, product innovation, and decision-making.
• Proven ability to identify opportunities for AI-enabled transformation across healthcare payer operations and technology platforms.
• Experience supporting large-scale healthcare technology modernization or digital transformation initiatives.

Responsibilities

Qualifications

Company