Senior Product Manager, Fraud & Abuse

• Lead the ongoing development and expansion of Fraud, Waste, and Abuse products delivering over $200M in annual impact
• Support CVS Health’s Payment Optimization Analytics objectives and revenue and ROI targets for analytics products
• Own product vision, strategy, and performance
• Identify and prioritize AI/ML integration opportunities
• Translate market trends, user feedback, and competitive intelligence into product direction
• Lead a cross-functional squad of data engineers, data scientists, and ideation team members
• Define and document the squad’s problem, priorities, and tradeoffs
• Develop and maintain roadmaps, backlogs, sprint plans, and demo materials
• Facilitate stakeholder sessions, sprint planning, working sessions, and product demos
• Evaluate AI/ML advancements for applicability to the product portfolio
• Establish and monitor product performance, adoption, and business-impact KPIs
• Develop data-driven business cases and secure stakeholder alignment and financial investment
• Ensure timely, high-quality delivery of product enhancements meeting business and technical requirements

Requirements

• 4+ years of experience in product management or product ownership
• 3+ years of experience within the healthcare industry
• Demonstrated experience managing product roadmaps and defining product requirements
• Proven ability to influence and collaborate effectively across cross-functional teams and senior stakeholders
• Ability to operate in ambiguity, translating evolving business objectives into clear, prioritized initiatives
• Experience leveraging AI/ML technologies to drive measurable business value
• Ability to analyze complex data and translate insights into actionable product strategy and business decisions
• Bachelor's degree or equivalent work experience with healthcare, claims processing, or vendor management
• Preferred: Experience in Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA)
• Preferred: Strong financial acumen, with the ability to assess business impact and drive value-based decisions
• Preferred: Experience working within Agile product management frameworks and methodologies
• Preferred: Working knowledge of healthcare claims processing, including end-to-end claims lifecycle

Core Competencies

Demonstrates expertise in product management within the healthcare sector, focusing on Fraud, Waste, and Abuse products. Proficient in leveraging AI/ML technologies to enhance product strategy and drive measurable business outcomes.

Highest-signal resume keywords

• Product Management
• AI/ML Integration
• Healthcare Industry Experience
• Agile Methodologies
• Financial Acumen

Hard Skills

• Product Roadmap Management
• Data Analysis
• Business Case Development
• KPI Monitoring
• Product Strategy Development

Soft Skills

• Cross-Functional Collaboration
• Stakeholder Influence
• Adaptability in Ambiguity

Industry Keywords

• Fraud, Waste, and Abuse
• Payment Integrity
• Claims Processing
• Vendor Management
• Business Impact Assessment