Senior Product Manager, Healthcare Payer Strategy
Oracle · United States
- Hybrid
- Full-time
- $187,000 / year
- United States
Job highlights
- Drive U.S. healthcare claims platform expansion.
- Define and deliver U.S. specific capabilities.
- Bridge customers and engineering teams.
- Shape product strategy with healthcare expertise.
- Modernize claims operations with technology.
About the role
About the Role
We are seeking a Product Manager to drive the expansion of Oracle's healthcare claims adjudication platform for the United States market. Our existing platform supports healthcare claims processing across multiple international markets. This role will focus on defining and delivering the capabilities required to meet the unique business, operational, and regulatory requirements of the U.S. healthcare system. Acting as the product owner for U.S.-specific adjudication functionality, you will work closely with health plans, healthcare organizations, implementation teams, and internal stakeholders to understand market needs and translate them into product requirements that guide development.
Key Responsibilities
A key responsibility of this role is enabling engineering teams to successfully build and deliver U.S. healthcare claims adjudication capabilities. You will engage directly with customers to demonstrate our solution, understand their claims processing workflows, gather requirements, document business rules, and define functional specifications that support product development. You will serve as the bridge between customers, healthcare domain experts, and engineering teams, ensuring that delivered capabilities align with market expectations and operational realities.
What You Will Do
- Serve as the product domain expert for U.S. healthcare claims adjudication capabilities.
- Engage with prospective and existing customers to demonstrate product functionality and communicate the value of Oracle's claims adjudication platform.
- Conduct customer workshops, discovery sessions, and requirements-gathering activities to understand claims processing workflows, business rules, and operational challenges.
- Translate customer needs into product requirements, user stories, functional specifications, and other product management artifacts.
- Collaborate closely with engineering teams to define solution designs and clarify business requirements throughout the development lifecycle.
- Support development teams by providing healthcare claims adjudication expertise and validating proposed solutions.
- Analyze market requirements and identify product enhancements needed to support U.S. healthcare payer operations.
- Contribute to product roadmap planning and prioritization for U.S.-specific capabilities.
- Partner with implementation, consulting, sales, and customer success teams to support customer adoption and successful deployments.
- Monitor industry trends, reimbursement models, and regulatory developments that may impact claims adjudication processes and product requirements.
- Act as a trusted advisor to internal stakeholders on U.S. healthcare claims processing and adjudication practices.
Who You Are
The successful candidate will possess deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes, including claims intake, benefit determination, pricing, reimbursement methodologies, edits, payment calculation, and claims lifecycle management. They will leverage this expertise to help shape product strategy, prioritize roadmap investments, and ensure our platform can effectively support the needs of U.S. healthcare payers.
Required Qualifications
- Deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes.
- Experience with healthcare payer operations, claims administration, claims adjudication systems, payment integrity, reimbursement, or related healthcare technology solutions.
- Experience in product management, business analysis, healthcare consulting, payer operations, or a related role.
- Proven ability to gather, document, and prioritize complex business and functional requirements.
- Strong customer-facing, presentation, and stakeholder management skills.
- Experience working directly with healthcare payers, health plans, third-party administrators, or healthcare technology vendors.
- Ability to translate complex claims processing requirements into software capabilities and functional solution designs.
- 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.
Preferred Qualifications
- Experience with commercial, Medicare, Medicaid, or government healthcare programs.
- Familiarity with healthcare claims standards and transactions, including X12 claims processing and related industry standards.
- Knowledge of value-based payment models and reimbursement methodologies, including Accountable Care Organizations (ACOs), bundled payments, shared savings arrangements, pay-for-performance programs, capitation, and other alternative payment models.
- Experience working in Agile software development environments.
- Knowledge of modern claims platforms, payment integrity solutions, utilization management systems, care management platforms, or core administration systems.
- Proven ability to use AI technologies to improve productivity, enhance decision-making, synthesize complex information, identify product opportunities, and strengthen collaboration across customers, product teams, and engineering organizations.
- Strong interest in emerging AI capabilities and a track record of evaluating and applying AI-driven approaches to solve business problems, improve operational efficiency, and drive innovation within healthcare technology environments.
About Oracle
Only Oracle brings together the data, infrastructure, applications, and expertise to power everything from industry innovations to life-saving care. And with AI embedded across our products and services, we help customers turn that promise into a better future for all. Discover your potential at a company leading the way in AI and cloud solutions that impact billions of lives. True innovation starts when everyone is empowered to contribute. That’s why we’re committed to growing a workforce that promotes opportunities for all with competitive benefits that support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs. We’re committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_mb@oracle.com or by calling 1-888-404-2494 in the United States. Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans’ status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
Key skills/competency
- Product Management
- Healthcare Payer Strategy
- Claims Adjudication
- U.S. Healthcare Industry
- Product Requirements
- Agile Software Development
- Stakeholder Management
- Customer Engagement
- AI Technologies
- Roadmap Planning
Skills & topics
- Product Manager
- Healthcare
- Payer Strategy
- Claims Adjudication
- Oracle
- U.S. Healthcare
- Product Management
- Business Analysis
- Agile
- Technology
How to get hired
- Tailor your resume: Highlight U.S. healthcare claims adjudication experience and product management skills.
- Craft a compelling cover letter: Emphasize your understanding of U.S. payer operations and regulatory needs.
- Prepare for technical questions: Be ready to discuss claims intake, benefit determination, and reimbursement methodologies.
- Showcase customer-facing skills: Demonstrate your ability to gather requirements and manage stakeholder relationships effectively.
- Understand Oracle's culture: Research their AI initiatives and commitment to healthcare innovation.
Technical preparation
Behavioral questions
Frequently asked questions
- What specific U.S. healthcare claims adjudication knowledge is required for this Senior Product Manager role at Oracle?
- This Senior Product Manager role at Oracle requires deep knowledge of U.S. healthcare industry and fee-for-service claims adjudication processes. This includes expertise in claims intake, benefit determination, pricing, reimbursement methodologies, edits, payment calculation, and claims lifecycle management. Familiarity with commercial, Medicare, and Medicaid programs is also highly preferred.
- Is U.S. citizenship a strict requirement for the Senior Product Manager, Healthcare Payer Strategy position at Oracle?
- Yes, U.S. citizenship is a strict requirement for this Senior Product Manager position at Oracle. This is due to the necessity of obtaining and maintaining a U.S. government security clearance after hire.
- What are the primary responsibilities of the Senior Product Manager in terms of customer interaction at Oracle?
- The Senior Product Manager will actively engage with prospective and existing customers to demonstrate product functionality, gather requirements through workshops and discovery sessions, and understand their claims processing workflows and challenges. They will translate these customer needs into product requirements and serve as a bridge between customers and engineering teams.
- How does Oracle leverage AI in its healthcare claims adjudication platform, and what experience is needed in this area for the Senior Product Manager role?
- Oracle embeds AI across its products and services. For this Senior Product Manager role, proven ability to use AI technologies to improve productivity, enhance decision-making, and identify product opportunities is highly valued. A strong interest in emerging AI capabilities and a track record of applying AI-driven approaches to solve business problems in healthcare technology are preferred.
- What is the typical career level for this Senior Product Manager role at Oracle, and what does that signify?
- This role is at Career Level IC3. This signifies an individual contributor role where you are expected to have a high level of expertise and autonomy in your domain, driving significant product initiatives and strategy within the U.S. healthcare payer market.
- What kind of benefits does Oracle offer to its employees, particularly for this Senior Product Manager position?
- Oracle offers a comprehensive benefits package including medical, dental, and vision insurance, disability and life insurance, flexible spending accounts, a 401(k) plan with company match, paid time off (vacation, holidays, sick leave), paid parental leave, adoption assistance, and an Employee Stock Purchase Plan.