Lead Product Manager, Claims Automation

About the role

This role will define and drive the product vision for our claims automation systems. You will be instrumental in shaping how we process claims, integrating AI and deterministic logic to ensure speed and accuracy. Your work will directly impact the efficiency and effectiveness of our healthcare platform.

Key facts

What you'll do

• Develop and maintain the product strategy and roadmap for claims automation, covering data intake, enrichment, adjudication, and routing.
• Become an expert in our operational workflows and translate them into technological solutions.
• Identify opportunities to apply AI/ML for tasks like document processing and routing, while also determining where rule-based systems are more appropriate.
• Establish frameworks for evaluating AI product performance, focusing on accuracy, safety, and user trust, and use these to guide release decisions.
• Design workflows that incorporate human oversight, maintain audit trails, and define escalation paths for a regulated financial system.
• Define key performance indicators for automated and semi-automated claims processes and use them to inform product releases.
• Make informed decisions regarding building new capabilities versus acquiring external solutions for claims infrastructure.
• Lead a dedicated team of engineers, designers, and data scientists to deliver significant product enhancements.
• Manage and execute complex, cross-functional projects, such as system migrations and new integrations.
• Translate regulatory requirements, like those from the No Surprises Act, into actionable product specifications.
• Collaborate closely with engineering, claims operations specialists, and compliance teams to define project scope, minimum viable products, and roadmap sequencing.
• Create detailed product requirement documents and specifications for technical and executive review.
• Utilize data and experimentation to measure the effectiveness of automated workflows and drive continuous improvement.
• Develop and refine product management practices suitable for a platform that combines infrastructure and intelligent systems.
• Stay informed about advancements in AI and identify potential product applications.
• Set challenging goals and ensure accountability for outcomes.

Requirements

• Bachelor's or Master's degree in Computer Science, Information Systems, Business Administration, or a related field.
• A minimum of 5 years of product management experience focused on processing systems involving workflows, queues, routing, and automation.
• Proven experience in bringing AI-powered products from initial concept to market launch, including managing the complexities of non-deterministic systems.
• A thorough understanding of AI agents and agentic architectures, with experience shipping systems where AI performs sequential actions.
• Experience in defining AI product quality metrics beyond standard A/B testing.
• A strong ability to design systems that are auditable and traceable, particularly within financial transaction and regulatory contexts.
• A good sense for user experience design, especially for data-intensive applications.
• Demonstrated skill in writing clear and precise specifications for both deterministic and non-deterministic systems, including evaluation methods.
• Experience collaborating with engineering on build, buy, or integrate decisions, including vendor assessments.
• Proficiency in SQL for data analysis.
• A deep understanding of Agile development methodologies.
• Ability to manage numerous interdependent tasks and communicate trade-offs to stakeholders.
• Experience working collaboratively across engineering, operations, compliance, and business teams.
• Must reside in California.

Nice to have

• Experience in claims processing, health insurance, or other regulated financial transaction domains.
• Startup experience, particularly in building products from scratch (0-to-1).

Skills & tools

• SQL
• Agile methodology
• AI/ML product development
• Product strategy and roadmap development
• Cross-functional team leadership
• Requirements gathering and documentation
• System design
• Data analysis and experimentation

Practical notes

• Competitive salary, bonus, and equity.
• Comprehensive medical, dental, and vision benefits.
• 401k retirement plan.
• Paid time off.