Product Development Coordinator/Manager POST NUMBER: 470431
100% remote in US only
What You’ll Do
1) Product Strategy & Roadmap
- Own the product strategy for claims intake, validation, adjudication, pricing, payment, remittance, audit, and related integrations (EHR, Enrollment, UM, Risk, Quality/NCQA, Coding Scrubber).
- Define and maintain a quarterly roadmap aligned to business OKRs, regulatory timelines, and client commitments; socialize priorities with Ops, Compliance, Finance, and Technology.
- Convert operational goals and regulatory constraints into epics, features, and user stories with clear acceptance criteria, edge cases, and non-functional requirements (auditability, throughput, privacy/security).
- Lead backlog grooming and sprint planning with offshore/onshore engineering; ensure requirements are unambiguous and testable.
- Serve as the product SME across the claims lifecycle; design claim edits and reference data strategies (NCCI, OCE, medicare pricing rules, COB/TPL, provider/plan configuration).
- Specify and validate EDI/X12 transactions: 837 (P/I/D), 835, 270/271, 276/277, 278; coordinate with clearinghouses and trading partners.
- Support standards and interoperability (HL7/FHIR, NCPDP for pharmacy).
- Drive UAT with Claims Ops; establish and monitor release gates for compliance, performance, and data quality (PHI handling, audit logs, error rates).
- Partner with QA to design scenario-based test suites and data validation for adjudication rules, pricing, and remittance advice.
- Ensure end-to-end adherence to HIPAA/HITECH, CMS guidance (including Medicare Advantage considerations), ERISA/state requirements, and internal security controls (RBAC, audit trails).
- Define product metrics and dashboards (Power BI/Tableau) for auto adjudication rate, first pass yield, claim touch rate, cycle time, payment accuracy, denial/appeal patterns, and operational throughput.
- Collaborate with Data Engineering on pipelines, reconciliations, and exception management; drive root?cause analysis for defects and leakage.
- Act as the day-to-day product point for Claims, Operations, Compliance, Client Services, and external vendors/clearinghouses; manage SLAs and integration timelines.
- Facilitate time zoneaware ceremonies with the offshore dev team (4 FTEs) and coordinate closely with the onshore PM and developer.
- Lead discovery to simplify workflows and increase automation; champion process and UX enhancements for adjusters, billing teams, and provider/client interfaces.
- Maintain a living configuration playbook (plan/benefit setup, pricing rules, enrollment tie-ins) to reduce errors and speed onboarding.
- 5–7 years in product management or solutions leadership in healthcare payer/TPA/MSO environments with direct ownership of claims platforms.
- Practical experience with EDI/X12 (837/835/270/271/276/277/278), claim adjudication rules, benefit configuration, and clearinghouse integrations.
- Proven ability to translate business/regulatory requirements into product specs and collaborate with engineering to ship iterative releases.
- Strong grounding in HIPAA, data privacy/security, and audit/compliance practices.
- Exposure to Medicare Advantage operations and CMS timelines; familiarity with NCQA quality programs and utilization management touchpoints.
- Technical fluency with one or more of: Azure, .NET/C#, Python, SQL; tooling like Azure DevOps/Jira/Confluence, Power BI/Tableau.
- Working knowledge of ICD 10, CPT/HCPCS, DRG/APC, provider contracting/pricing, COB/TPL, prior authorization workflows.
- Experience collaborating with offshore engineering teams, managing cross time zone delivery.
Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company’s 401(k) retirement plan. Additional disclaimer: Unless otherwise noted in the job description, the position Vaco/Highspring is filing for is occupied. Please note, however, that Vaco/Highspring is regularly asked to provide talent to other organizations. By submitting to this position, you are agreeing to be included in our talent pool for future hiring for similarly qualified positions. Submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied. Further assessment of candidates beyond this initial phase within Vaco/Highspring will be otherwise assessed by recruiters and hiring managers. Vaco/Highspring does not have knowledge of the tools used by its clients in making final hiring decisions and cannot opine on their use of AI products.
Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.
EEO Notice
Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.
Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact HR@vaco.com .
Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.
By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.
Privacy Notice
Vaco by Highspring and its parents, affiliates, and subsidiaries (“we,” “our,” or “Vaco by Highspring”) respects your privacy and are committed to providing transparent notice of our policies.
- California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here.
- Virginia residents may access our state specific policies here.
- Residents of all other states may access our policies here.
- Canadian residents may access our policies in English here and in French here.
- Residents of countries governed by GDPR may access our policies here.
Pay Transparency Notice
Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to:
- the individual’s skill sets, experience and training;
- licensure and certification requirements;
- office location and other geographic considerations;
- other business and organizational needs.
With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.