Product Manager, Clinical Programs & Case Management

Company :

Job Description : 

JOB SUMMARY

*If you are located within a 50 mile radius of our Pittsburgh Office or Buffalo NY office this will be a hybrid role requiring in office 3 days a week (T/W/Th)

The Product Manager is responsible for defining and advancing the strategy, roadmap, and performance of a portfolio of clinical programs and care management solutions that improve member outcomes, enhance the healthcare experience, and drive business value. This role serves as the primary connector between business, clinical, operational, analytic, and technology teams to identify opportunities, develop solutions, and ensure delivery of products and programs that support Highmark's Living Health strategy.

The Product Manager owns the end-to-end lifecycle of assigned products and programs, from opportunity identification and business case development through launch, optimization, measurement, and ongoing portfolio management. The role requires strong healthcare domain expertise, strategic thinking, data-driven decision making, and the ability to influence cross-functional stakeholders across a complex healthcare ecosystem. This position focuses on ensuring that we are building the right products, capabilities, and member experiences to improve health outcomes, reduce avoidable costs, simplify healthcare navigation, and increase member engagement.

Key Responsibilities

• Define product strategy, vision, and roadmaps for clinical programs, care management solutions, and supporting capabilities, ensuring alignment with business priorities and member needs.
• Lead products and programs through their entire lifecycle, from opportunity identification and business case development through implementation, measurement, optimization, and retirement.
• Partner across clinical, operational, analytics, technology, digital, and vendor teams to align priorities, drive execution, and deliver business and member outcomes.
• Design and evolve clinical programs, member journeys, and engagement strategies that improve health outcomes, member experience, quality performance, and affordability.
• Establish success measures, monitor product performance, and leverage data, analytics, and market insights to drive continuous improvement and value realization.
• Serve as the voice of the member, customer, and business while influencing stakeholders, managing competing priorities, and leading strategic decision-making across the portfolio. 

ESSENTIAL RESPONSIBILITIES

• Understand the department's and the company's strategic roadmap and competitive position, and develops a holistic product vision and the corresponding product strategy to drive maximum value. Clearly set and communicate roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.
• Actively anticipates future needs and utilizes metrics and qualitative input to identify asset improvement opportunities.
• Represent the product in all governance meetings.
• Clearly sets and communicates roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.
• Serve as accountable owner for the sets of products/tools within the designated portfolio.
• Identify and drives both cross-product and cross-customer value and shared learnings.
• Own the product backlog and uses input from internal and partner teams to frequently refresh and re-prioritize the backlog.
• Other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in science, technology, mathematics or related field OR relevant experience and/or education as determined by the company in lieu of bachelor’s degree

Preferred

• None

EXPERIENCE

Required

• 3 years of Product experience

To Include:

• 3 years with the Software Lifecycle
• 1 year of Advanced domain experience

Preferred

• Experience leading cross-functional initiatives in a matrixed environment.
• Strong analytical, strategic planning, and business case development skills.
• Experience working with healthcare data, performance metrics, and outcome measurement.
• Excellent communication, stakeholder management, and executive presentation skills.

• Experience within a health plan, managed care organization, payer, provider, or population health environment.
• Knowledge of care management, Stars/HEDIS measures, population health, utilization management, quality programs, or value-based care.
• Experience supporting digital health, member experience, or clinical technology solutions.
• Product Management certification or Agile experience.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Business Acumen for P&Ls
• Communication
• Conflict Management

Key words:  Clinical Programs, Case Management, Care Management, Population Health, Health & Wellness, Product Manager, Product Roadmap, Product Lifecycle, Business Case Development, Portfolio Management, Program Design, Health Outcomes, Member Experience, Stakeholder Management, Cross Functional Leadership, Data Driven Decision Making, Medicare Advantage, STARS/ HEDIS, ID& Strat, Risk Stratification, Health Navigation, Population Health Management, Clinical Operations, Disease Management, Transitions of Care, Quality Programs, ROI/KPI, Vendor Management, Process Optimization, Outcome Measurement, Stakeholder Management.

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.