Health Product Manager, Claims

XO Health is hiring a Product Manager for Claims to own the product vision and strategy for its in-house claims processing platform. The role sits between the business and engineering, turning claims operations, EDI, and payer requirements into a roadmap the technical team can build against. It is a remote position based in India, and the company is a health plan built for self-insured employers.

What you will do

• Define and own the product vision and strategy for the claims processing platform, working with Engineering, Claims Operations, and executive stakeholders.
• Build and maintain the product roadmap, planning the order in which adjudication logic gets built while integrating pricing, EDI transactions, and payment features.
• Set timeline goals and milestones, balancing business urgency, technical feasibility, and dependencies across teams.
• Translate long-term strategy into sprint-level priorities and explain tradeoffs to leadership when scope, timeline, or resourcing conflicts come up.
• Serve as the primary liaison between business stakeholders and the technical team throughout the build.
• Draft business requirements and user stories for claims adjudication, pricing, EDI transaction handling (837, 835, 834), and claim adjustment workflows.
• Translate claims processing rules — CARC/RARC and group codes, duplicate detection, accumulator management, medical necessity edits, correct-coding logic, workflow design, and business rules — into requirements engineers can build against.
• Partner with engineering on solution design, review technical approaches for feasibility, and flag business risk or compliance concerns early.
• Own acceptance criteria and take part in user acceptance testing to confirm delivered functionality meets business intent before release.
• Run discovery with cross-functional teams to surface pain points, edge cases, and process gaps in current claims handling.
• Identify, manage, and mitigate risks and dependencies for each release.
• Own and groom the product backlog, prioritizing features and fixes based on business impact, regulatory requirements, and platform dependencies.
• Define and track success metrics including accuracy, turnaround time, auto-adjudication rate, and denial/appeal volume.
• Work with Claims Operations, EDI, Network, Compliance, Legal, and client-facing teams so the platform reflects real operational and contractual needs.
• Partner with vendor management and clearinghouse/EDI partners on transaction standards, connectivity, and migration workstreams.
• Coordinate with Data, Analytics, and Reporting teams so the platform supports downstream reporting, audit, and regulatory needs.
• Plan and support release management, including phased rollouts, provider and client communication, and training materials for internal teams.
• Monitor platform performance and user feedback after launch and maintain a continuous improvement backlog.
• Document product decisions, business requirements, and process changes for institutional knowledge and audit needs.

What they are looking for

• Experience in US healthcare, health insurance, claims operations, or employee benefits, with working knowledge of the claims lifecycle, adjudication, and payment processes.
• 5+ years of product management experience, including owning a product roadmap and strategy from discovery through launch.
• A demonstrated ability to draft clear, detailed business requirements and user stories and to serve as a liaison between business stakeholders and technical teams.
• Strong analytical and problem-solving skills, with the ability to translate complex operational rules into structured product requirements.
• Experience managing a product backlog and roadmap, setting priorities, and communicating timeline tradeoffs to stakeholders and leadership.
• Excellent written and verbal communication skills, with the ability to work across business, operations, and engineering teams.
• Comfort operating in an ambiguous, fast-paced environment where the tools and processes are still being built.

Preferred

• Bachelor's degree in business, health administration, computer science, or a related field.
• Experience with claims adjudication platforms, claims pricing engines, and EDI transaction standards (837, 835, 834, 277).
• Familiarity with CARC/RARC denial coding, UB-04 and CMS-1500 claim forms, and claims adjustment workflows.
• Experience with self-funded health plans, TPAs, or value-based care organizations.
• Familiarity with Agile/Scrum product development practices and tools.
• Experience partnering with clearinghouses, payer portals, or claims vendors.

Pay, hours, and location

The salary range is INR 2,500,000 to 3,500,000 per year. Full compensation packages are based on candidate experience and relevant certifications. The role is remote in India, and you must be able to support USA business hours, with flexibility for cross-functional and vendor meetings. Occasional collaboration outside standard hours may be needed to support key releases or milestones.

About XO Health

XO Health describes itself as the first health plan designed by and for self-insured employers, aiming to deliver a more unified health experience for those who receive care, those who deliver it, and those who pay for it. The company is building a multi-disciplinary team and its own claims processing platform to power claims adjudication, pricing, and payment. XO Health is an equal opportunity employer and promotes a drug-free workplace.