Product Owner, Payment Integrity

At Zelis, we Get Stuff Done. So, let’s get to it! 

A Little About Us 

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

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

What You’ll Do

Ownership

• Build, maintain, refine, and prioritize the Data Mining team backlog.
• Translate roadmap initiatives, business requirements, analytical concepts, and operational needs into features, user stories, enabler stories, and acceptance criteria.
• Ensure backlog items are clearly defined, appropriately sequenced, and ready for delivery.
• Balance functional requirements, technical enablement, defect resolution, operational improvements, and nonfunctional requirements.
• Work with product leaders to ensure backlog priorities remain aligned with the product roadmap.
• Communicate changes in scope, priority, dependencies, and delivery risk.

Agile Planning and Execution

• Participate in PI Planning, sprint planning, backlog refinement, daily stand-ups, sprint reviews, retrospectives, and Product Owner synchronization activities.
• Present story details and priorities to Agile teams.
• Support estimation and capacity discussions with Engineering, Data Science, and other delivery partners.
• Coordinate dependencies with other product and delivery teams.
• Resolve requirement questions and provide timely clarification during development.
• Accept completed stories after confirming that acceptance criteria and the Definition of Done have been met.
• Participate in system demonstrations and ensure delivered functionality is presented to appropriate stakeholders.

Requirements and Solution Definition

• Partner with key stakeholders to document detailed requirements.
• Translate data mining methodologies into understandable system, workflow, data, reporting, and user requirements.
• Document expected inputs, outputs, business rules, exception handling, user interactions, and operational workflows.
• Collaborate with Architecture and Engineering to understand technical enablers and document their business relevance.
• Identify gaps, conflicts, and unclear requirements before work enters development.
• Support workflow diagrams, wireframes, process maps, and data flow documentation as appropriate.
• Translate AI, machine learning, and automation requirements into clearly defined user stories, acceptance criteria, workflow requirements, and nonfunctional requirements.
• Document requirements related to human review, explainability, confidence thresholds, exception handling, auditability, monitoring, and escalation.
• Partner with tech teams to ensure AI-enabled features are testable and operationally understandable.

Testing and Release Support

• Partner with QA and business stakeholders to define test scenarios and expected results.
• Support functional testing, user acceptance testing, defect triage, and release validation.
• Confirm delivered functionality meets business requirements.
• Coordinate with the Product Manager and Operations on release readiness.
• Support release notes, internal documentation, training materials, and knowledge transfer.
• Help monitor releases and rapidly identify issues requiring backlog action.
• Support validation and acceptance testing of AI-enabled functionality, including expected outputs, exception scenarios, workflow impacts, and human-in-the-loop controls.
• Confirm that AI-generated or AI-assisted outputs meet approved acceptance criteria before release.

Stakeholder Collaboration

• Gather detailed feedback from users and convert actionable needs into backlog items.
• Facilitate decisions when stakeholders have conflicting requirements.
• Maintain transparency regarding sprint priorities, delivery progress, and impediments.
• Support continuous improvement of Agile delivery and product development practices.

What You’ll Bring to Zelis

• Bachelor’s degree or equivalent relevant experience.
• 4+ years of experience in product management, business analysis, or a related role.
• Experience developing user stories, acceptance criteria, business requirements, functional specifications, or test scenarios.
• Experience managing or contributing to an Agile team backlog.
• Knowledge of Agile software development lifecycle practices.
• Strong analytical, troubleshooting, process-mapping, and communication skills.
• Ability to organize complex information and translate it into clear delivery requirements.
• Ability to manage multiple priorities in a fast-moving environment.
• Experience supporting AI, analytics, machine learning, automation, or data-intensive product delivery.
• Familiarity with model outputs, confidence scoring, decision-support workflows, and responsible AI controls.

Preferred Qualifications

• Healthcare or Payment Integrity experience. (Including Data Mining, FWA, COB or the like)
• Experience with healthcare claims data, reimbursement, clinical review, or claims auditing.
• Experience supporting analytics, data science, or data platform products.
• Working knowledge of SQL; coding is not required.
• SAFe Product Owner/Product Manager, CSPO, CPO, or comparable certification.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility

Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out ourlocations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies.

While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.

Base Salary Range

At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.

Zelis’ full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

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 welcome applicants from all backgrounds and encourage you to apply even if you don’t meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. 

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 emailTalentAcquisition@zelis.com. 

Disclaimer 

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.