Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Technical Product Manager role for Clinical solutions merges product management, healthcare expertise, and technical knowledge to develop and manage software and technology solutions for Alignment Health. Technical Product Managers work with business stakeholders and engineering teams to translate complex regulatory and operational requirements into actionable technical solutions. This role will drive the strategy, roadmap, and delivery of Clinical software solutions. The Technical Product Manager will ensure the platform delivers scalable, compliant, and efficient Clinical technology solutions that drive improved healthcare out-comes, regulatory compliance, and operational efficiency for Alignment's Care Management teams.
Job Duties/Responsibilities:- Drive the functional and technical roadmap for Clinical Solutions, including Utilization, Care Management platforms, Clinical decision support systems, quality measures, and interoperability solutions leveraging Alignment's proprietary AVA and Vendor platforms.
- Ensure compliance with CMS, NCQA, HIPAA, and other regulatory requirements impacting clinical data and processes.
- Anticipate regulatory and operational changes (e.g., CMS rule updates, encounter data submission requirements) and integrate them into the roadmap.
- Lead the design, testing, and implementation of new features for Clinical solutions platforms.
- Define and drive integration with Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and other clinical data platforms via APIs, HL7, FHIR, and batch interfaces.
- Partner with data engineering teams to design solutions that support risk adjustment, HEDIS/Stars quality reporting, care gap closure, and population health analytics.
- Define and prioritize features for provider-facing tools such as prior authorization, utilization management, case management, and clinical documentation improvements.
- Collaborate with clinicians, business stakeholders, and technology teams to translate clinical workflows and requirements into scalable technical solutions.
Job Requirements:Experience:- 5+ years of Product Management experience in healthcare technology, with a focus on clinical solutions.
- Advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred.
- Proven hands-on expertise with:
- Healthcare interoperability standards (FHIR, HL7, X12, CCD, CDA)
- Microsoft SQL (querying, optimization, reconciliation, audits)
- ETL Tools such as Microsoft SSIS and Azure Data Factory
- Cloud Platforms (Azure/AWS)
- Experience integrating vendor solutions.
- Strong knowledge of clinical workflows, care management, utilization management, and quality reporting.
- Strong analytical, problem-solving, and communication skills with the ability to translate technical details into business outcomes.
Education:- Bachelor's degree in Healthcare Information Systems, Computer Science or related field; advanced degree or clinical background (RN, PharmD, MPH, etc.) strongly preferred.
- MBA or advanced degree preferred.
Specialized Skills:- Deep understanding of Provider Credentialing, Contracting and Reimbursement Strategies in a Medicare environment.
- Experience with Medicare and Medicaid programs, including Stars, HEDIS, and risk adjustment.
- Knowledge of clinical natural language processing (NLP) or AI-driven care management tools.
- Proficiency in relevant technical tools, such as SQL, Azure Data Factory, Jira, and Confluence.
- Experience in defining product strategies, managing product backlogs, and working within agile development methodologies.
- Familiarity with payer platforms (Facets, QNXT, HealthRules) and provider EMRs (Epic, Athena, Cerner, Allscripts).
- Vendor management and SLA performance oversight.
Pay Range: $113,332.00 - $169,999.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com.
