Technical Product Manager, CMS Interoperability and EMR Integrations

Job Title: Technical Product Manager, CMS Interoperability and EMR Integrations

^Remote Work

• Must be authorized to work in USA with a valid VISA/GC/USC
  
  
  

Role Overview:

We are seeking a driven Technical Product Manager to own the technical vision, strategy, and execution for our CMS Interoperability and EMR Integrations teams. You will be the bridge between our business objectives and our engineering teams, ensuring we build scalable, reliable, and market-leading technical solutions following federal and state regulatory requirements using the HL7 FHIR implementation guides.

Responsibilities:

• Strategy & Vision: Assist management in defining the product vision, strategy, and roadmap, aligning with overall business goals and regulatory compliance deadlines.
• Regulatory analysis and interpretation: Strong understanding of CMS Interoperability and Prior Authorization regulations, including CMS-0057-F and its impact on payers and providers. Analyze and interpret the CMS-0057-F rule and related FHIR Implementation Guides (IGs), such as CARIN BB, US Core, Da Vinci PDEX, and Da Vinci CRD, DTR, and PAS, to translate complex regulatory requirements into detailed technical specifications.
• Requirements gathering: Collaborate with product managers, product owners, operational, and technical stakeholders to define the business and data requirements for implementing new FHIR-based APIs and updating existing ones.
• Cross-Functional Leadership: Collaborate closely with Engineering, Design, UHC/Optum Business Units and Operations to ensure successful development, launch, and adoption.
• Technical Expertise: Provide technical guidance, review architectural decisions, and ensure solutions meet the regulatory requirements.
• Privacy and Security Standards: Knowledge of data privacy and security regulations, such as HIPAA, to handle sensitive patient information during data exchange.
• Interoperability standards: Subject matter expert with related healthcare standards such as HL7 v2, CCDA, USCDI, and clinical terminology like SNOMED, LOINC, CPT, etc.
• Documentation and reporting: Develop comprehensive documentation, including data flow diagrams, FHIR API specifications, and test results. Assist in generating the CMS Interoperability Patient Access API and prior authorization metrics required for public reporting to CMS.
• Stakeholder engagement: Provide technical guidance and education on HL7 FHIR standards to business and technology teams to drive adoption and alignment with CMS requirements.
• Agile Execution: Drive the product development lifecycle using Agile methodologies (Scrum/Kanban), managing sprints, backlogs, and releases.
• Soft skills: Strong analytical, problem-solving, and collaboration skills, with meticulous attention to detail.
  
  
  

Qualifications:

• Bachelor's degree in Health Informatics, Computer Science, Engineering, or a related technical field.
• Proven experience (3 years) in technical product management or a similar role with several years’ in an analysis role.
• Strong understanding of software development principles, architectures, and best practices.
• Experience with Agile/Scrum development methodologies.
• Excellent communication skills, able to articulate complex technical concepts to both technical and non-technical audiences.
• Deep knowledge of CMS 9115 Patient Access API and CMS 0057 CMS Interoperability and Prior Authorization in the healthcare and health insurance arenas.
• Ability to read and understand HL7 FHIR implementation guidelines to ensure the products being developed comply accordingly.
• Ability to analyze data, manage risks, and make data-driven decisions in a fast-paced environment managing multiple projects.
  
  
  

Preferred Qualifications

• HL7 FHIR certification.
• Experience in the payer domain with a strong understanding of payer workflows and data management.
• Experience with cloud-based data platforms (e.g., AWS, Azure).
  
  
  

Bonus Points:

• Experience with EHRs and solid experience in the healthcare industry.
• Data mapping source to target experience.
  
  
  

This is a remote position.