Glint Tech Solutions LLC
CLINICAL PRODUCT OWNER (PRIOR AUTHORIZATIONS SME)
COMPANY OVERVIEW
Glint Tech Solutions is a women-owned global staffing and IT recruiting firm dedicated to connecting exceptional talent with industry-leading opportunities across the US and beyond. We partner with top-tier clients across healthcare, technology, finance, and logistics to place high-caliber professionals in roles that truly make an impact.
PROJECT DESCRIPTION
Our client is seeking a highly experienced Clinical Product Owner and Business Integration Lead with deep expertise in clinical prior authorizations to drive a complex, cross-functional initiative focused on the complete analysis and potential redesign of the prior authorization process. This is a lead-level, fully remote position requiring a true SME in Prior Authorizations, FACETS, 278 transactions, and Claims Processing. The ideal candidate brings 15+ years in healthcare and payer operations, with the last 8+ years in a Clinical Product Manager capacity. Day-to-day responsibilities include engaging clinical, business, and IT stakeholders to analyze current PA workflows, identify pain points, and drive meaningful process improvements.
KEY RESPONSIBILITIES
- Lead cross-functional meetings with clinical, business, and IT stakeholders to analyze current prior authorization processes
- Identify pain points and drive resolutions to improve PA workflows end-to-end
- Support complete analysis and potential redesign of the client’s prior authorization process
- Serve as primary SME for Clinical Prior Authorizations, FACETS, 278 transactions, and Claims Processing
- Deliver executive-level reporting and manage complex, multi-stakeholder initiatives
- Translate clinical and business requirements into actionable product and integration strategies
MANDATORY SKILLS
- 15+ years in healthcare delivery, payer operations, UM, or PA programs
- Last 8+ years as a Clinical Product Manager or Business Integration Lead
- End-to-end knowledge of Clinical Prior Authorizations — critically important
- FACETS expertise
- Claims processing knowledge
- 278 transaction experience
- Basic working knowledge of GuidingCare
- Excellent communication, stakeholder management, and executive-level reporting skills
- Must be US-based
NICE-TO-HAVE SKILLS
- Experience leading prior authorization process redesign initiatives
- Background working with large healthcare payers or managed care organizations
- Familiarity with UM/PA regulatory and compliance frameworks
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
Working in United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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