Provider & Claims Technology Product Senior Director

Role Summary

We are seeking a senior Technical Product leader to own and evolve the technology product portfolio supporting Claims and Provider Engineering. This role sits at the intersection of technology, business strategy, and operations, ensuring that platform investments are aligned to enterprise priorities, regulatory needs, and measurable value delivery.

This leader will be a critical partner during portfolio planning and annual budget cycles, translating business outcomes into executable product roadmaps while balancing modernization, run-the-business stability, and innovation. The role requires deep credibility with engineers and equal fluency with executive business and operations leaders.

• Own the end-to-end product strategy and roadmap for claims and provider technology platforms (adjudication, provider data, pricing, payment integrity, integrations, digital gateways, etc.)
• Translate business, operational, and regulatory needs into clear product visions, backlogs, and measurable outcomes
• Drive prioritization decisions across BAU, modernization, and transformation initiatives

• Serve as a core contributor during portfolio planning and annual budget cycles for claims and provider domains
• Partner with finance, business, and technology leaders to:
  • Build investment cases and value narratives
  • Balance funding across run, grow, and transform portfolios
  • Track benefits realization, cost optimization, and ROI
• Support trade-off decisions with data-driven insights on capacity, risk, and value

• Act as the primary product interface for claims operations, provider operations, network, finance, and business leadership
• Ensure technology roadmaps align to operational workflows, SLAs, regulatory timelines, and provider/member experience goals
• Facilitate executive-level discussions on sequencing, dependency management, and delivery risk

• Partner closely with engineering leaders and architects to shape scalable, resilient, and modular platform strategies
• Ensure products are built with operability, observability, security, and extensibility in mind
• Guide adoption of modern engineering practices (API-first, cloud-native, event-driven, automation, AI-enabled capabilities)

• Establish product governance, intake, and prioritization models across claims and provider portfolios
• Define and track product KPIs (availability, performance, cycle time, cost, adoption, CX/PX impact)
• Drive transparency through executive-ready reporting and roadmap communications

• 10+ years of experience in product management, platform product ownership, or technology strategy
• Proven experience leading complex, multi-stakeholder technology portfolios
• Strong understanding of claims and/or provider technology ecosystems (adjudication, provider data, contracting, pricing, EDI, integrations)
• Demonstrated experience partnering with business, operations, and finance leaders
• Hands‑on experience with portfolio planning, budgeting, and investment governance
• Ability to translate deeply technical concepts into clear executive narratives

• Experience in healthcare payer environments
• Familiarity with core claims platforms (e.g., Facets, IMS, mainframe or modernized equivalents)
• Experience managing products across regulated, high‑availability platforms
• Exposure to AI‑enabled products, automation, or digital companion tools
• Prior experience operating in large-scale transformation or modernization programs

• Executive presence with a builder’s mindset
• Comfortable navigating ambiguity and competing priorities
• Strong influencer without reliance on direct authority
• Financially literate with a value‑first product mindset
• Bias toward action while protecting platform stability

This role is a keystone position for aligning claims and provider technology investments to enterprise strategy. The leader will directly shape portfolio decisions, funding outcomes, and long‑term platform health, while enabling better experiences for operations…