Product Owner, Payment Integrity

Own and prioritize payment integrity data mining work for Agile and/or Kanban delivery teams, translating strategy into backlog-ready requirements.

Responsibilities

• Build, maintain, refine, and prioritize the Data Mining team backlog.
• Translate roadmap initiatives, business requirements, analytical concepts, and operational needs into features, user stories, enabler stories, and acceptance criteria.
• Keep backlog items clearly defined, appropriately sequenced, and delivery-ready.
• Balance functional requirements, technical enablement, defect resolution, operational improvements, and nonfunctional requirements.
• Partner with product leaders to ensure backlog priorities stay aligned to the product roadmap.
• Communicate scope, priority, dependencies, and delivery risk changes to stakeholders.
• Participate in PI Planning and team ceremonies including sprint planning, backlog refinement, daily stand-ups, sprint reviews, retrospectives, and Product Owner synchronization.
• Present story details and priorities to Agile teams; support estimation and capacity discussions with Engineering, Data Science, and other delivery partners.
• Coordinate dependencies with other product and delivery teams.
• Resolve requirement questions and provide timely clarification during development.
• Accept completed stories after confirming acceptance criteria and the Definition of Done are met.
• Participate in system demonstrations and ensure delivered functionality is presented to relevant stakeholders.
• Partner with key stakeholders to document detailed requirements for data mining, including system/workflow/data/reporting/user requirements.
• Document expected inputs and outputs, business rules, exception handling, user interactions, and operational workflows.
• Work with Architecture and Engineering to understand technical enablers and document their business relevance.
• Identify gaps, conflicts, and unclear requirements before work enters development.
• Support workflow diagrams, wireframes, process maps, and data flow documentation as appropriate.
• Translate AI, machine learning, and automation requirements into clear user stories, acceptance criteria, workflow requirements, and nonfunctional requirements.
• Document requirements for human review, explainability, confidence thresholds, exception handling, auditability, monitoring, and escalation.
• Partner with tech teams to ensure AI-enabled features are testable and operationally understandable.
• Collaborate with QA and business stakeholders to define test scenarios and expected results.
• Support functional testing, user acceptance testing, defect triage, and release validation; confirm delivered functionality meets business requirements.
• Coordinate with Product Manager and Operations on release readiness.
• Support release notes, internal documentation, training materials, and knowledge transfer.
• Help monitor releases and rapidly identify issues requiring backlog action.
• Support validation and acceptance testing for AI-enabled functionality, including expected outputs, exception scenarios, workflow impacts, and human-in-the-loop controls.
• Confirm AI-generated or AI-assisted outputs meet approved acceptance criteria before release.
• Gather user feedback and convert actionable needs into backlog items.
• Facilitate decisions when stakeholders have conflicting requirements.
• Maintain transparency regarding sprint priorities, delivery progress, and impediments; support continuous improvement of Agile delivery and product development practices.

Requirements

• Bachelor’s degree or equivalent relevant experience.
• 4+ years of experience in product management, business analysis, or a related role.
• Experience creating user stories, acceptance criteria, business requirements, functional specifications, or test scenarios.
• Experience managing or contributing to an Agile team backlog.
• Knowledge of Agile software development lifecycle practices.
• Strong analytical, troubleshooting, process-mapping, and communication skills.
• Ability to organize complex information and translate it into clear delivery requirements.
• Ability to manage multiple priorities in a fast-moving environment.
• Experience supporting AI, analytics, machine learning, automation, or data-intensive product delivery.
• Familiarity with model outputs, confidence scoring, decision-support workflows, and responsible AI controls.

Technologies

• SQL
• AI
• Machine learning
• Automation
• Data mining

Benefits

• 401k plan with employer match
• Flexible paid time off
• Holidays
• Parental leaves
• Life and disability insurance
• Health benefits including medical, dental, vision, and prescription drug coverage

Preferred Qualifications

• Healthcare or Payment Integrity experience, including data mining, FWA, COB, or similar.
• Experience with healthcare claims data, reimbursement, clinical review, or claims auditing.
• Experience supporting analytics, data science, or data platform products.
• Working knowledge of SQL; coding is not required.
• SAFe Product Owner/Product Manager, CSPO, CPO, or comparable certification.

Location and Work Environment

• Morristown, NJ (onsite)
• Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India.
• Employee work locations are based on the needs of the position and determined by Leadership.
• In-office work and activities vary based on work and team objectives per Company policies.
• Candidates within approximately 50 miles of a U.S. office are generally preferred for collaboration needs.
• Hybrid approach is flexible; in-office presence is guided by team and business needs rather than a fixed weekly schedule.

Salary

• Base salary range: $105,000.00 - $133,000.00

Accessibility Support

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, email [email protected].