Sr. Director Product - Expert Claims Review

Position Overview: The Sr. Director of Product, Expert Claims Review (ECR) is responsible for leading product management across Zelis' Expert Claims Review and Data Mining portfolio, including Diagnosis-Related Group (DRG) Review, Clinical Chart Review (CCR), Itemized Bill Review (IBR), and supporting features like our Document Retrieval functions within Zelis' Payment Integrity business. This leader translates the broader Payment Integrity strategy into coordinated product plans across the ECR portfolio. The Senior Director establishes portfolio priorities, oversees product roadmaps, guides investment recommendations, and ensures Product Managers and Product Owners are aligned around customer needs, business objectives, and operational requirements. The role works closely with Payment Integrity Operations leadership, Technology, Sales/Client Management, executive leadership and other key stakeholders. Success requires strong healthcare product leadership, payment integrity knowledge, sound commercial judgment, and the ability to lead effectively within a complex matrixed organization. The role is also responsible for developing product leadership capability, strengthening succession pipelines, and advancing the responsible use of AI and automation across the ECR portfolio.

Leadership and Organizational Capability: Create clarity in complex or ambiguous situations and align leaders around enterprise priorities, tradeoffs, and intended outcomes, while promoting consistent product lifecycle management practices across the portfolio. Lead transformation initiatives across Product, Operations, and Technology while balancing short-term execution with long-term portfolio value. Build, coach, and develop Product Managers, Product Owners and Business Analysts alike, including talent planning and leadership development. Foster a culture of accountability, transparency, sound judgment, continuous improvement, and responsible experimentation. Influence senior leaders across a matrixed organization without relying on direct authority. Identify and remove organizational barriers that limit product performance, speed, scalability, or customer value. Review and approve product roadmaps, investment recommendations, business cases, and major release plans. Establish clear accountability between portfolio strategy, product roadmap ownership, and Agile delivery execution. Establish product governance, planning cadences, and performance reporting.

Customer and Market Leadership: Maintain an understanding of payer needs, healthcare reimbursement trends, competitive offerings, and emerging payment integrity capabilities. Engage with strategic clients and prospects to understand business challenges and product needs. Partner with key stakeholders on product positioning, client presentations, requests for proposals, and strategic growth opportunities. Represent the ECR portfolio in executive client discussions and internal leadership forums. Ensure client requests are evaluated consistently against strategic fit, market applicability, operational impact, and expected return.

Cross-Functional Leadership: Partner closely with Operations leadership to ensure products can be delivered consistently, efficiently, and at scale. Collaborate with keys senior leaders to ensure product capabilities are accurate, defensible, and technically feasible. Align with Implementation and Client Management teams regarding client readiness, product changes, and adoption. Escalate and resolve cross-functional issues that affect product performance or portfolio delivery. Sponsor major product transformation and modernization initiatives. Support change management, release readiness, and communication for significant portfolio changes. What You'll Bring to Zelis Bachelor's degree in a related field, or commensurate experience.10+ of product management, healthcare technology, payment integrity, or related experience.5+ years of leadership experience managing product or comparable teams. Demonstrated experience managing a portfolio of complex healthcare products or services. Demonstrated experience leading enterprise change and influencing senior stakeholders in a matrixed environment. Strong knowledge of healthcare claims, reimbursement, clinical review, or payment integrity processes. Experience developing product roadmaps, evaluating investments, and managing products throughout their lifecycle. Experience evaluating or implementing AI, automation, analytics, or decision-support capabilities in a regulated environment. Demonstrated ability to work with executive leaders, clients, technical teams, and operational organizations. Strong financial, analytical, communication, and decision-making skills. Experience operating effectively in a matrixed organization. Preferred

Qualifications: Master's degree or MBA.Direct experience with solutions in the ECR portfolio. Experience with pre-payment and post-payment integrity solutions. Experience modernizing technology-enabled healthcare services. SAFe, Pragmatic Institute, Product School, or comparable product management certification. Understanding of responsible AI principles, including governance, explainability, privacy, human oversight, and performance monitoring. 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 our locations 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$185,000.00 - $234,650.00At 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 email TalentAcquisition@zelis.com.DisclaimerThe 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.

Job number: JR111708Profession: Product