Job Summary
We are seeking a strategic and execution-oriented Product Owner / Solution Architect with deep health plan provider data expertise to lead the product strategy, roadmap execution, and cross-functional delivery of a modern provider data platform. This role will own the end-to-end product lifecycle for the organization's provider data ecosystem — establishing a scalable "system of truth,” driving API-enabled modernization, and implementing a formal provider data quality and governance program. The ideal candidate combines strong product management discipline, program execution leadership, and solution architecture depth within complex payer environments.
Primary Responsibilities
Product Strategy & Roadmap Ownership
- Define and own the multi-quarter product roadmap for provider data modernization
- Prioritize initiatives based on business value, risk reduction, automation impact, and regulatory requirements
- Establish KPIs for provider data accuracy, reconciliation cycle time, API adoption, and platform utilization
- Manage backlog, define epics and user stories, and support Agile delivery cycles
- Drive stakeholder alignment and executive visibility into roadmap progress
Platform Modernization & Integration Leadership
- Establish the provider data platform as the enterprise system of record / system of truth
- Lead the transition from manual and batch-based processes to API-driven integrations
- Define integration strategy across CAQH, Symplr, Cactus, Facets, and downstream systems
- Partner with engineering to define technical requirements and scalable architecture patterns
- Evaluate system handoffs and eliminate integration gaps across credentialing and core administration platforms
Provider Data Domain & Workflow Optimization
Apply deep understanding of health plan provider workflows including:
- Credentialing
- Contracting
- Provider enrollment
- Directory management
- Roster reconciliation
- Downstream data distribution
- Map current-state workflows and define future-state optimized models
- Identify automation opportunities that reduce manual reconciliation and operational risk
- Standardize data flows across credentialing and core administrative systems
Data Quality & Governance Program Leadership
- Design and implement a formal Provider Data Quality Framework
- Define measurable data quality KPIs (accuracy, timeliness, completeness, reconciliation variance)
- Establish validation rules, monitoring dashboards, and escalation workflows
- Improve and scale weekly reconciliation processes
- Create governance standards across source systems and downstream consumers
- Ensure alignment and consistency across CAQH, Symplr, Cactus, Facets, and the provider data platform
- Build durable documentation for both manual and automated processes
Cross-Functional Delivery & Program Leadership
- Act as the primary liaison between operations, credentialing, provider network, IT, and engineering
- Drive structured intake, prioritization, and delivery governance processes
- Distribute work across project teams and ensure alignment with overall product strategy
- Provide architectural oversight for API and development initiatives
- Potentially serve as U.S.-based functional/technical lead for expanding API and engineering capabilities
- Drive adoption and change management across business stakeholders
Education and Experience
- 8+ years in health plan operations, provider data management, payer IT, or healthcare product environments
- Proven experience in Product Owner, Product Manager, Program Manager, or Solution Architect roles
- Deep expertise in provider data lifecycle management
- Hands-on experience with: CAQH, Facets, Cactus, Symplr Payer
- Experience leading cross-functional product initiatives from strategy through delivery
- Experience improving provider data accuracy and reconciliation processes
- Experience modernizing integrations (batch to API transitions)
- Strong understanding of provider data integration patterns and API architecture
- Experience building and managing product roadmaps and backlogs
- Ability to translate complex business workflows into structured technical requirements
- Experience designing system-of-truth and data governance frameworks
- Familiarity with compliance and provider directory regulatory requirements
- Experience working with distributed engineering teams in Agile environments