Job Description
Insight Global is seeking a Principal Product Manager – Claims & Encounters to join a critical project with one of the largest consulting and advisory firms in the world. This role will support the modernization of state-level Medicaid systems by driving end‑to‑end product ownership of new claims and encounter management capabilities. The ideal candidate will operate at the intersection of product, policy, compliance, and engineering—ensuring operational systems reflect evolving CMS and state requirements. This individual will partner closely with cross‑functional teams to deliver user‑facing tools that increase transparency, improve data quality, and streamline reporting. In this role, you will help modernize a fragmented ecosystem into a more integrated, accurate, and accountable operational platform.
Responsibilities
Translate strategic requirements for modernized claims and encounter operations into actionable roadmaps aligned to major milestones and regulatory deadlines.
Own the design, development, and continuous improvement of submission, validation, reconciliation, and reporting capabilities for internal and external users.
Build user-facing workflows that provide counties, providers, and managed care plans with visibility into submission status, data quality, and reconciliation outcomes.
Develop product features that reinforce accountability for data quality at the point of submission.
Ensure claims and encounter systems integrate effectively with adjacent Medicaid operational systems.
Translate CMS and California-specific regulatory and reporting obligations into implementable product requirements.
Ensure alignment with federal interoperability standards (USCDI, HL7, FHIR) and standardized healthcare code sets.
Partner with engineering, data, finance, and compliance teams to embed validation, quality controls, and reporting logic into core workflows.
Define measurable product outcomes tied to compliance, reconciliation accuracy, timeliness, and operational performance.
Collaborate with internal policy, program, and executive stakeholders to align product decisions with system-wide transformation goals.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
10+ years of product management experience in healthcare technology or Medicaid system development.
Direct ownership experience with Medicaid claims and/or encounter systems.
Deep knowledge of claims adjudication workflows, encounter reporting processes, and CMS Medicaid reporting requirements.
5+ years’ experience with CPT, HCPCS, ICD, and other standardized healthcare code sets.
5+ years’ hands-on experience with healthcare interoperability standards (USCDI, HL7, FHIR).
Proven experience translating regulatory or policy requirements into product/system functionality.
Nice to Have Skills & Experience
Experience modernizing or consolidating fragmented claims or encounter systems.
Familiarity with MITA and Medicaid Enterprise modernization methodologies.
Experience building submission engines, validation services, or transaction gateways.
Public-sector, managed care, or government healthcare consulting experience.
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.