Owns the strategy, backlog, prioritization, requirements, delivery, compliance, and lifecycle of enterprise claim-processing custom solutions. Translates business and regulatory needs into user stories and acceptance criteria, leads Agile ceremonies, accepts delivered work, manages risks, and partners with engineering, data, QA, operations, health plans, compliance, legal, and audit teams.
Job Description
Lead enterprise claim processing Custom Solutions product strategy by setting direction and priorities, governing requirements and solution design, and aligning stakeholders on regulatory, operational, and business outcomes. Own lifecycle decisions from BRD approval through testing, release, production risk, traceability to guide deployment, decommissioning and core-system transitions.
Preferred Skills:
- QNXT Knowledge
- Claim Processing/Claim Lifecycle Knowledge
- Intermediate Reporting/Data Mining
Job Summary
Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations. Owns the product vision, backlog, and delivery outcomes and serves as the primary bridge between business stakeholders and technical delivery teams.
Defines what is built and why, ensuring solutions align to business outcomes, regulatory requirements, and enterprise strategy, while partnering closely with engineering, architecture, data, QA, and operations teams on how solutions are delivered. Maintains ownership of products across the full lifecycle—from discovery and intake through implementation, stabilization, optimization, and eventual retirement.
Job Duties
- Owns and communicates a clear product vision aligned to enterprise strategy and operational outcomes.
- Maximizes product value by continuously prioritizing work based on business impact, regulatory requirements, risk, dependencies, and sustainability.
- Acts as the single point of accountability for product decisions, tradeoffs, and acceptance of delivered work.
- Serves as the primary escalation point for scope, priority, and requirement decisions.
- Owns the end‑to‑end product lifecycle, including enhancements, defect prioritization, technical debt, and modernization efforts.
- Creates, refines, and maintains a prioritized product backlog reflecting stakeholder needs and technical realities.
- Writes and maintains high‑quality epics, features, and user stories with clear acceptance criteria.
- Leads backlog refinement and actively participates in Agile ceremonies (planning, reviews, retrospectives).
- Accepts or rejects completed work based on defined acceptance criteria, quality standards, and regulatory alignment.
- Partners with business stakeholders to understand problems, desired outcomes, constraints, and regulatory obligations.
- Collaborates closely with engineering, architecture, data, QA, operations teams, and Health Plans to ensure solutions are feasible, scalable, and supportable.
- Translates complex technical concepts into business‑understandable terms and business needs into actionable technical requirements.
- Understands and supports leadership escalation protocols.
- Ensures product delivery aligns with security, regulatory, audit, and compliance requirements.
- Partners with health plan, compliance, legal, and audit teams as needed to support reviews and implementations.
- Ensures product documentation, controls, and artifacts remain current, accurate, and audit‑ready.
- Proactively identifies delivery risks and works with teams to mitigate impacts.
- Monitors product performance, usage, and outcomes; uses data and feedback to inform backlog priorities.
- Identifies opportunities for automation, optimization, and simplification of solutions.
- Supports enterprise goals related to standardization and reduction of unmanaged complexity.
- Owns one or more defined products or product areas with moderate complexity.
- Works under established product strategy, governance, and prioritization frameworks.
- Partners closely with stakeholders to clarify requirements and translate needs into backlog items.
- Manages competing priorities within a defined scope and escalates complex tradeoffs as needed.
- Demonstrates growing autonomy in backlog management, delivery decisions, and stakeholder engagement.
Job Qualifications
REQUIRED QUALIFICATIONS:
- At least 5 years of experience in product ownership, product management, business analysis, or technical solution delivery.
- Demonstrated experience working within Agile/Scrum delivery models.
- Experience supporting technical products such as enterprise platforms, configuration tools, data solutions, integrations, or operational systems.
- Strong understanding of software development lifecycles and Agile principles.
- Proven ability to write clear, testable user stories and acceptance criteria.
- Experience prioritizing work in complex, highly regulated environments.
- Strong analytical and problem‑solving skills.
- Excellent communication skills with the ability to influence across technical and non‑technical audiences.
- Ability to operate effectively in ambiguity and make decisions with incomplete information.
PREFERRED QUALIFICATIONS:
- Prior Product Owner or Product Manager certification strongly preferred at time of hire.
- Experience with enterprise platforms, APIs, integrations, or configuration‑heavy systems.
- Experience in healthcare, financial services, or other regulated industries.
- Familiarity with Agile tooling (e.g., Jira, Azure DevOps, Rally).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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