[Remote] Sr. Product Manager- Payment Integrity

Note: The job is a remote job and is open to candidates in USA. Codoxo is the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud, waste, and abuse. As Sr. Product Manager-Payment Integrity, you’ll be responsible for managing Payment Integrity products, driving the strategy and execution for the product suite while collaborating with various teams to deliver scalable solutions. Responsibilities • Own the product roadmap for Data Mining and Complex Claim Audit management products • Lead customer discovery with health plan audit teams, claims operations leaders, and clinical reviewers - going beyond surface-level requests to uncover generalizable workflow needs • Define product requirements across audit types (e.g., DRG validation, clinical validation, itemized bill review, data mining concepts), identifying common platform patterns while accounting for audit-type-specific logic • Shape the GenAI-powered medical record review experience, making critical product decisions about what to automate, where human judgment is essential, and how to design auditor-in-the-loop workflows • Collaborate with engineering and data science teams to deliver high-quality products, providing the domain context they need to build effectively • Partner with clinical SMEs and auditors to validate requirements, test assumptions, and ensure domain accuracy • Drive go-to-market readiness working with sales, marketing, and implementation teams on positioning, enablement, and launch • Make principled trade-off decisions - resisting one-off customization requests in favor of scalable, configurable product solutions that serve the broader market • Manage the Codoxo Payment Integrity products and ensure they meet the defined success metrics • Work closely with Codoxo data science, product engineering, customers, customer success, and Codoxo payment integrity experts to define and execute the roadmap for payment integrity products • Support product marketing to create content for internal and external stakeholders Skills • Bachelor's in Engineering, Computer Science, technical related field, or equivalent practical experience • 5+ years of professional experience in payment integrity, claims auditing, or claims operations - as a product manager, auditor, audit manager, solutions architect, or operations leader • 3+ years in a Product Management role at a B2B SaaS or healthcare technology company, with direct ownership of roadmap, backlog, and delivery working alongside engineering teams • Working knowledge of multiple audit types with an understanding of how claims are identified for audit, how medical records are reviewed, and how findings are documented and recovered • Experience building or contributing to products that scale - you can point to examples where you turned domain-specific knowledge into configurable, platform-level product capabilities rather than customer-specific features • Comfort working with AI/ML-powered products - you don't need to be a data scientist, but you can reason about automation vs. human review trade-offs, provide feedback on model outputs, and design workflows where AI and human expertise complement each other • Strong customer discovery and stakeholder management skills - you can lead a conversation with a VP of Payment Integrity and an audit nurse with equal confidence, and translate what you learn into clear product direction • Proven experience in gathering and prioritizing product requirements into a meaningful product roadmap • Experience with Agile software methods • A learning and growth mindset with an ability to self-start on problems, a willingness to own problems, and a desire to make things better • You must demonstrate a strong product sense and have experience working with design teams • You can lead without giving orders and argue a viewpoint persuasively • You can write, speak, and think about complicated and highly technical problems with lucidity • Physical Requirements: Work is performed in an office environment (either in our office or work-from home) and requires the ability to work on a computer, operate standard office equipment, and work at a desk • Prior hands-on operational experience in claims or auditing before transitioning to a product or technology role - former auditors, audit team leads, or claims operations managers who moved into product bring invaluable workflow intuition • Experience managing products at different lifecycle stages simultaneously - maintaining and growing a mature product while launching a new one • Familiarity with clinical documentation, medical coding, and classification systems (ICD-10, CPT, DRG grouping, medical record abstraction) • Understanding of health plan IT ecosystems - claims adjudication platforms, EDI transactions (835/837), provider data, and how audit workflows integrate with core administrative systems • Experience working directly with data science or machine learning engineering teams on products that involve model-generated outputs reviewed by human users • Prior experience with analytics, healthcare payment integrity or revenue cycle management products is a plus • Proven record of product management accomplishments with demonstrated market success Benefits • Health, Dental, and Vision insurance with 100% employee premium coverage (Starts Day 1) • Unlimited PTO • Annual Professional Development stipend • Annual home office stipend • 401K Match (after 90 days) Company Overview • Codoxo leverages advanced generative and self-learning AI to enhance payment integrity in healthcare. It was founded in 2017, and is headquartered in Duluth, Georgia, USA, with a workforce of 51-200 employees. Its website is https://www.codoxo.com.