Availity is one of the leading health information networks in the United States, processing more than 4 billion transactions annually and connecting more than two million healthcare providers and over two thousand technology partners to health plans nationwide. Our teams of technology, business, and customer service professionals in Bangalore, India, are working together to transform healthcare delivery in the United States through innovation and collaboration. Our technologists help develop cutting-edge revenue cycle solutions that help hospitals, health systems, and physicians maximize payments and optimize their workflows.
Availity is a diverse group of people whose talents, curiosity and passion steer the company to create innovative solutions for the US Healthcare industry. If you are a driven, creative and collaborative individual, with exceptional technology skills to drive innovation, we want to hear from you.
• The ideal candidate will bridge the gap between business and technical teams to optimize prior authorization processes and reporting capabilities.
• You will serve as the subject matter expert (SME) for prior authorization workflows and interoperability standards, bridging business and technical teams to deliver innovative solutions that meet CMS mandates and industry needs.Roles & Responsibilities
About Availity
Availity is a leading healthcare technology company focused on simplifying healthcare administration and solving real-world challenges for healthcare providers, health plans, and patients. Our technology helps reduce complexity, so providers can spend less time navigating administrative systems and more time focused on patient care.
About Availity India
Availity India is an important part of Availity's global growth journey. Based in Bengaluru, our India team’s partner closely with U.S. and global stakeholders across technology, product, operations, customer support, and corporate functions.
Our India organization is being built with a strong focus on ownership, learning, collaboration, engineering excellence, and meaningful business impact. Associates in India have the opportunity to solve complex problems, contribute to global initiatives, and support products and services that are part of the U.S. healthcare ecosystem.
About the Role
We are seeking a Product Manager with expertise in prior authorization workflows and interoperability. This role will focus on implementing interoperable solutions that streamline prior authorizations, medical necessity reviews, and payer-provider workflows while ensuring compliance with regulatory guidelines.
The ideal candidate will bridge the gap between business and technical teams to optimize prior authorization processes and reporting capabilities.
You will serve as the subject matter expert (SME) for prior authorization of workflows and interoperability standards, bridging business and technical teams to deliver innovative solutions that meet CMS mandates and industry needs.
Key Responsibilities
Why you want to work on this team:
Work on cutting-edge solutions that have the potential to reshape prior authorization processes across the healthcare industry.
Engage in meaningful work that drives disruption, accountability, and positive change for payers and providers.
Be part of a team that values innovation and collaboration, positioning Availity as a leader in interoperability and burden reduction.
To be qualified for this position you have:
Deep expertise in prior authorizations workflows. This is required to be considered for the role.
Strong technical background with an understanding of the CMS 0057-F requirements for prior authorization and the X12 278 EDI and FHIR prior authorization (CRD, DTR, and PAS) transactions.
Knowledge of EHR systems and payer utilization management platforms and vendors.
Product management or related role, preferably in healthcare technology.
Business acumen: ability to contribute to a business case, evaluate feasibility & scalability, and driving ROI.
Familiarity with regulatory requirements and compliance standards.
Proven ability to lead cross-functional initiatives and influence stakeholders.
You will set yourself apart with:
Familiarity with Agile/Scrum, product management tools (Jira, Aha), and EHR systems
Proficiency in analyzing data and finding actionable insights.
Knowledge of the full revenue cycle is a plus.
What you will be doing:
Product Strategy & Vision: Define and communicate a clear product roadmap aligned with CMS requirements, industry trends, and organizational goals.
Product Ownership: Manage the full lifecycle for new features and enhancements, from ideation through launch and adoption.
Client Engagement: Collaborate directly with providers, payers, and vendors to gather requirements, conduct demos, and ensure successful launches of features and integrations.
Cross-Functional Leadership: Collaborate with engineering, data, and delivery teams to ensure timely, compliant, and scalable product releases.
Roadmap & Prioritization: Define and prioritize product features based on industry trends, regulatory mandates, client feedback, and ROI considerations.
Pilot & Launch Oversight: Lead pilots, define KPIs/OKRs, and drive successful go-to-market strategies.
Expert in FHIR Standards: Serve as the internal authority on FHIR standards for prior authorization, guiding product design, engineering decisions, and compliance efforts.
External-Facing Expert: Represent Availity as a subject matter expert in prior authorization interoperability at client meetings, industry workgroups, and conferences; provide thought leadership and educate external stakeholders.
Industry Collaboration: Participate in industry workgroups such as Da Vinci Burden Reduction to stay ahead of interoperability standards.
Cross-Functional Support: Partner with sales, marketing, and client success teams to deliver product demos, training, and analytics-driven insights.
Why Join Availity India?
Meaningful impact: Work on solutions that help simplify healthcare administration and support better provider and patient experiences.
Global exposure: Partner with U.S. teams and leaders while contributing from India to global business priorities.
Learning and growth: Be part of a culture that values continuous learning, mentoring, knowledge sharing, and career development.
Flexible work experience: Work in a way that supports productivity, collaboration, and team needs across remote, hybrid, and office-based models.
Holistic rewards: Benefit from competitive compensation, health and insurance benefits, paid time off, company holidays, leave benefits, Employee Assistance Program support, and learning programs.
Inclusive workplace: Join a casual, collaborative, and inclusive environment where associates are encouraged to bring ideas forward.
Office experience: For office-based associates, Availity India provides amenities such as coffee and tea, subsidized meals, recreation areas, and eligible night-shift transportation support.
What to Expect from the Hiring Process
Our hiring process is designed to be transparent and engaging. Depending on the role, it may include application review, recruiter discussion, technical or functional assessment, hiring manager interviews, team or leadership conversations, offering discussion, background verification, and onboarding support.
Equal Opportunity Statement
Availity is committed to building an inclusive workplace where all associates feel valued, respected, and empowered to do their best work. We welcome candidates from diverse backgrounds and encourage individuals who are excited by collaboration, innovation, and meaningful impact to apply.
Video Camera Usage:
Availity fosters a collaborative and open culture where communication and engagement are central to our success. As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.
Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.
