Contract Modeling Product Manager
Sign up free to see how well your resume matches this role.
What you'll do
- Lead the definition and delivery of a healthcare contract modeling platform roadmap, requirements, and product backlog.
- Translate complex payer contract language into detailed business rules, user stories, and technical specifications.
- Design and validate reimbursement modeling logic, including DRG, APC, per diem, case rate, stop-loss, outlier, and other payment methodologies.
- Partner with software engineers, architects, QA teams, and external development partners to deliver scalable product functionality.
- Support AI-powered contract extraction and automation initiatives by validating contract interpretation, establishing review processes, and defining governance standards.
- Gather customer and market requirements to enhance future capabilities such as underpayment detection, contract compliance, scenario modeling, revenue forecasting, and strategic pricing.
What they're looking for
- 5+ years of experience in healthcare reimbursement, managed care contracting, revenue cycle, or contract management.
- Bachelor's degree required in Healthcare Administration, Business, Finance, Information Systems, or a related field.
- Expertise interpreting commercial payer contracts and reimbursement models, including DRG, APC, per diem, and case-rate methodologies.
- Experience gathering business requirements and partnering with software development teams to deliver technology solutions.
- Strong knowledge of healthcare financial data, claims adjudication, and reimbursement analytics.
- Candidates must be legally authorized to work in the United States. This position is not eligible for employment visa sponsorship now or in the future.
Nice to have
- Preferred experience with product ownership, contract modeling platforms, Agile development, and AI-driven document automation.
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
At Kodiak Solutions, we’re dedicated to transforming the healthcare industry through cutting-edge, technology-driven solutions. We specialize in healthcare finance, unclaimed property, risk management, and revenue cycle management, helping healthcare organizations streamline complex financial operations. Our mission is to simplify and optimize processes, so healthcare providers can focus on delivering excellent patient care.
Powered by our innovative platform, we offer cloud-based systems, automated workflows, and advanced data management tools designed to address the unique challenges in healthcare. Whether it's improving revenue cycle efficiency, navigating unclaimed property issues, or mitigating risk, our platform delivers real-time, actionable insights to drive better outcomes.
The Contract Modeling Product Manager has the responsibility of leading the design and development of a next-generation healthcare contract modeling platform that transforms complex payer contract terms into scalable business rules and product functionality. This role serves as the key liaison between reimbursement subject matter experts, product leadership, and software development teams, driving requirements gathering, backlog prioritization, contract modeling logic, and product delivery.
Essential Duties and Responsibilities may include the following. Other duties may also be assigned.
• Lead the definition and delivery of a healthcare contract modeling platform roadmap, requirements, and product backlog.
• Translate complex payer contract language into detailed business rules, user stories, and technical specifications.
• Design and validate reimbursement modeling logic, including DRG, APC, per diem, case rate, stop-loss, outlier, and other payment methodologies.
• Partner with software engineers, architects, QA teams, and external development partners to deliver scalable product functionality.
• Support AI-powered contract extraction and automation initiatives by validating contract interpretation, establishing review processes, and defining governance standards.
• Gather customer and market requirements to enhance future capabilities such as underpayment detection, contract compliance, scenario modeling, revenue forecasting, and strategic pricing.
Qualifications:
• 5+ years of experience in healthcare reimbursement, managed care contracting, revenue cycle, or contract management.
• Bachelor's degree required in Healthcare Administration, Business, Finance, Information Systems, or a related field.
• Expertise interpreting commercial payer contracts and reimbursement models, including DRG, APC, per diem, and case-rate methodologies.
• Experience gathering business requirements and partnering with software development teams to deliver technology solutions.
• Strong knowledge of healthcare financial data, claims adjudication, and reimbursement analytics.
• Preferred experience with product ownership, contract modeling platforms, Agile development, and AI-driven document automation.
• Candidates must be legally authorized to work in the United States. This position is not eligible for employment visa sponsorship now or in the future.
Company
Company facts come from this company's own listings. We only show what the postings themselves carry.