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