At Zelis, we Get Stuff Done. So, let’s get to it! A Little About Us Zelis is modernizing the healthcare financial experience for all by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview The Expert Claims Review Product Owner is a key member of the Price Optimization business unit, who should be able to operate within and help drive an Agile Scrum Team as well as being capable of leading & driving small to large scale initiatives outside of the Agile Scrum structure. This Product Owner will be working within the Expert Claims Review Product team and aligned with the Expert Claims Review operational team with a focus on Itemized Bill Review, Clinical Chart Review, and Document Retrieval for both pre-payment and post-payment products. This position will work in close partnership with Business Operations, Ideation, Sales, IT, and Implementation departments in the development and maintenance of the current product(s) as it relates to scalability, functionality, and initiatives imperative to growth. This position also oversees business processes including support for communication, documentation, and knowledge transfer for release and operational support readiness. Enhancements to operational efficiencies, technology advances and process improvements will be a key focus of this role. Within Agile TeamAs a member of the Agile Team, the Product Owner is responsible for partnering with our Business Analysts in defining all User Stories, Acceptance Criteria, and helping the team keep on track with iteration delivery. This role has significant relationships and responsibilities outside the local team, including working with Product Management, Customers, Business Owners, and other internal stakeholders.Outside the Agile TeamThe Product Owner is a member of the Enterprise Product Team and has direct accountability for operationalizing a Market In product strategy that is inclusive of competitive analysis, market assessment, operational and technical roadmaps, as well as sales and enterprise goals. This accountability includes proactive identification of roadmap capabilities, joint prioritization of intake requests, as well as collaboration across leadership teams to ensure alignment and validation.Additionally, some initiatives may be run as projects outside the Agile execution structure and the candidate must be able to demonstrate experience in managing & driving medium to complex sized projects, unsupervised. This should include knowledge of project management techniques, including managing issues, risk mitigation, planning, etc. What You’ll Do + Contribute to the end-to-end Product Lifecyle Management for responsible Products. + Maintain a deep understanding of the business needs and the factors driving the impact and priority. + Support and analysis in ensuring data driven delivery of product roadmap; Return on Investment assessment, business impact analysis, goal alignment, operational impact analysis, etc. + Translating these business needs into User Stories which the Agile team can understand and work from. + Applying the concepts of Minimum Viable Product (MVP), to shape “what to work on next.” + Being able to take the initiative and make decisions, to keep the team moving forward. + Preparation and Participation in PI Planning + As a member of the extended Product Management team, the Product Owner is heavily involved in program backlog refinement and prep for Program Increment (PI) planning and plays a significant role in the planning event itself. + Sprint Execution + Maintaining the team backlog – With input from System Architect/Engineering and other stakeholders, the Product Owner has the primary responsibility for building, editing, and maintaining the team backlog. + Sprint Planning – The Product Owner reviews and reprioritizes the backlog as part of the prep work for Sprint Planning, and communicates story detail and priorities and ensures the team aligns and agrees on a final Sprint plan. + Just-in-time story elaboration – Most backlog items are elaborated into user stories and acceptance criteria for implementation. The Product Owner should be able to write user stories or help guide others with this task. + Accepting stories – The Product Owner works with the team to agree on accepted story completion. This includes validating that the story meets acceptance criteria, its Definition of Done (DoD), etc. + Understand enabler work – While Product Owners are not expected to drive technological decisions, they should be able to understand and document the scope of the upcoming enabler work in collaboration with System and Solution Architect/Engineering. + Participate in team demo and retrospective – Product Owner collaborates with their team and any other stakeholders in the team demo and Sprint Retrospective. + Program Execution + During each PI, the Product Owner coordinates dependencies with other Product Owners. This often occurs in regularly scheduled Product Owners sync events. The Product Owners also has an instrumental role in ensuring the production of any system demos for stakeholder evaluation and review. + Content Authority + SAFe leverages several artifacts such as Features, Stories, Non-Functional Requirements, design artifacts, and so forth, to guide the ART in creating the solution. + Program and Team Backlog(s) govern the prioritization of these work items. They are managed by the Product Manager and the Product Owner who provide the content authority of their respective backlogs. + Participate in relevant Agile ceremonies: Daily Stand-Ups, Backlog Grooming, Sprint Planning, Sprint Review, Sprint Retrospective. + Assist with the elaboration of the user stories and requirements, supporting team members with their work where required. + Be responsible for providing multi-disciplinary teams with user stories and coaching to define the business-driven acceptance criteria and test cases. Proactively support the uplift of Agile practices and foster a culture of continual service improvement. + Consult with the business, business analysts and other product owners to prioritize and shape the product backlog, using Agile practices for prioritization around business value. + Define, implement, and maintain business processes and procedures to meet business objectives. Analyze and identify opportunities for business process improvements. + Collaborate with Solution Owners and/or other Product leaders when defining product release content and timeline, applying product development principles, innovative thinking and a focus around the customer or user experience. + Critically evaluate information gathered from multiple sources, reconcile conflicts, and decompose high-level information into details. + Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements. + Create training materials and documentation for internal and/or external applications. + Perform a thorough gap analysis of existing to potential functionality for internal and/or external applications. + Perform analysis and identify gaps in functionality for system integrations. + Collaborate with the Scrum team to establish the technical vision and analyze tradeoffs between usability and performance needs. + Improves systems by studying current practices, designing modifications. + Assist in Quality Assurance (QA) and/or User Acceptance Testing (UAT) of new software or enhancements to existing software as needed. + The ability to multi-task and work on multiple assignments will be required. + This individual must also demonstrate clear and concise communication both verbally and in writing. + Travel requirements to (primarily) domestic destinations should not exceed 10%. What You’ll Bring to Zelis + Disciplined, structured and logical approach to problem solving. + 4+ years of experience with Business Analysis and/or Product Owner prior roles. + Experience in Healthcare industry preferred. + Knowledge of Payment Integrity solutions (hospital billing, claims editing, reimbursement methodologies and acceptable billing practices) preferred. + Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards preferred. + SQL experience preferred, however coding will not be required. + The ability to learn a new business and translate these needs into new products, and perform high-level troubleshooting functionality. + Strong troubleshooting, analytical, and business process development skills + Experience in product development life cycle. + Experience with writing business requirements, technical requirements, user stories, enabler stories, functional specifications, and/or quality assurance testing. + Knowledge of SDLC methodologies including experience working in an Agile environment. + Fluent with Microsoft Office Suite including Visio. + Workflow diagram creation and wireframe creation. + SAFe POPM, CPO, CSPO, Agilist, Teams, or Leading Safe certification preferred. + Bachelors degree preferred. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. Commitment to Diversity, Equity, Inclusion, and Belonging At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com. SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis. Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.