Product Manager, Capitation Adjudication

About the role

Cedar Gate Technologies, an IQVIA business, is looking for a Product Manager to support the continued enhancement and delivery of its Capitation Adjudication platform. The role suits someone who has worked directly within a health plan or managed care organization and understands the operational realities of payer administration, claims processing and capitation management. It works closely with Product, Engineering, Quality Assurance, Operations, Client Services and Implementation teams. The position is remote, open to U.S. residents only, and the potential base pay range is $88,100 to $220,200 annually.

Key responsibilities

• Manage and prioritize product enhancements and backlog items for the Capitation Adjudication platform
• Gather, analyze and document business requirements and operational use cases
• Develop user stories, functional requirements and acceptance criteria
• Collaborate with engineering and QA teams throughout the software development lifecycle
• Take part in Agile planning, backlog refinement, sprint reviews and release preparation
• Evaluate enhancements through the lens of real-world payer operations and client needs
• Support implementation, testing, release readiness and post-release activities
• Partner with stakeholders on product improvements and operational efficiencies
• Assist with product demonstrations, client discussions and subject-matter expertise
• Contribute to product roadmap planning

Required profile

• Bachelor's degree in Healthcare Administration, Information Systems, Business Administration or a related field, or equivalent experience
• Seven or more years of experience in healthcare payer, managed care or health plan operations
• Five or more years of hands-on experience with Capitation Adjudication (e.g., EZ-CAP) in a production environment
• Experience supporting payer operations after go-live, including issue resolution, process improvements and system enhancements
• Experience gathering business requirements and translating them into functional solutions
• Strong communication, organizational and stakeholder management skills
• Preferred: experience with multiple functional areas (claims, authorizations, benefits, provider administration, EDI), value-based care, risk-based payment models, and previous client-side support of the EZ-Cap platform

Required skills

• Agile or Scrum-based software development environments
• Preferred: JIRA, Confluence, SQL, reporting tools or healthcare operational reporting
• Preferred: CSPO, Agile certification or similar professional certifications