Vice President, Utilization Management Product Applications

Job Location US-Remote | US-TX-Dallas | US-Remote
Job ID


Medecision is transforming healthcare one cool app at a time!


Are you the kind of person that is motivated by the challenge of a dynamic, changing market? Can you utilize and exploit progressive systems and processes to satisfy urgent business needs? Are you a good partner with your teammates; driven to execute team and individual commitments that align with business vision? Does the idea of a high visibility and high impact role in a medium sized, growing company excite you? Are you interested in being part of a team that strives to achieve high business impact, execution excellence and has a lot of fun while we are doing it? Are you ready? We are! Join us in our journey towards liberating today’s fragmented healthcare systems to Connect Care Everywhere.


We are looking for a Vice President, Utilization Management Product Applications, a passionate power contributor who blends experience bringing new product to market with the vision and drive to contribute to revenue growth. As one of our Product Applications’ VPs, you will drive the product suite vision, strategy and roadmap, working closely with your team and others in Engineering to drive the Product Development Lifecycle Management efforts. You will establish and execute on solid business cases to inform strategic investment decisions, define the go-to-market strategy and develop the sales revenue forecast to include revenue projections, cost to develop, profitability and pricing. You will also closely partner with the entire product organization to identify linkages and support the full product portfolio and vendor partner ecosystems. Additionally, you will partner with others in Engineering to drive the Product Development Lifecycle Management efforts in our Agile environment, along with Marketing to drive go-to-market strategy. You must also enjoy spending time in the market to understand customers’ vision and pain points, while being able to identify, co-create and deliver innovative solutions for the broader market. Above all, you will act as a pioneer and strategist to lead our full PHM spectrum product strategies forward in the healthcare industry.




You, as the Vice President, Utilization Management Product Applications, have deep knowledge and expertise in building successful product solutions related to Revenue & Payment Management, Risk & Cost Mitigation and Revenue Generation Applications. You will bring expertise in the areas of provider network management, utilization, referrals, authorizations, and alternative payment models such as bundles, ACOs, DSRIP, MACRA. This is critical to drive core needs, and pain points across Health plan, Government MCO, and Provider segments. You will be responsible for a SaaS-based product portfolio, which also includes integrating data, analytics, workflows, and consulting services into compelling offerings. You are a customer champion who instills confidence from the existing customer base and prospects on the product vision & direction, and execution of specific apps.


Reports to:  SVP, Product Applications

Location(s): Wayne, PA; Dallas, TX; Remote




  • Managing the entire product development lifecycle (PDL) from concept to strategic planning to tactical activities. Working with Engineering to have product input into the Software Development Life Cycle (SDLC).
  • Defining, designing, developing, and deploying commercial technology solutions for the Care Management Workflow including Government, Payor, Provider, Revenue Cycle.
    • Create, maintain and continue enhancements to a market-aligned product vision and roadmap
    • Engage internal and external stakeholders and subject matter experts to understand and prioritize market needs and to develop a vision and strategy for delivering on those solutions
    • Define specific product requirements, identify users and stakeholders, and assist in the development of prototypes and other models
    • Lead your teams to articulate market requirements, and work with other product managers, partners and clients to create a market-aligned vision and roadmap
    • Drive a solution set across development teams (primarily Marketing Communications and Development/Engineering) through market requirements, product contract, and positioning.
    • Communicate the roadmap internally and externally, and engaging with prospects and clients
    • Inform press and industry analysts
  • Developing packaging and pricing that is aligned with market needs and achievement of revenue goals
    • Develop a business case, creating and managing to a budget that includes product management and development dollars
    • Identify critical success factors for the product
    • Identify and execute on Go-To-Market plans and deliverables including client engagement, sales enablement, collateral and demos
    • Develop the core positioning and messaging for the product
    • Set pricing to meet revenue and profitability goals
  • Providing leadership to sales and account management teams, conducting webinars and presenting at industry leading forums
    • Develop sales tools and collateral
    • Propose an overall budget to ensure success
    • Deliver a monthly revenue forecast
    • Brief and train the sales, sales support teams at quarterly meetings
  • Analyzing potential partner relationships for the product
  • Being an expert with respect to the competition




  • Bachelor’s degree required; MBA or MHA strongly preferred
  • 15+ years’ experience with deep operating expertise within Population Health Management, to include:
    • Utilization Management, Referrals and Authorizations, Appeals and Grievances
    • Exposure to the unique requirements of Government plans across the spectrum of major government programs:
      • Medicare/Medicaid and sub-populations/programs
      • MSSP
      • Duals
      • Medicare Advantage Plans
      • Government Incentive Programs from CMS that Medicare and Medicaid programs are subject to, such as: Bundles, DSRIP, STARS/HEDIS, etc.
    • Understanding of interoperability, HIE and analytics, which includes on industry standard data feeds, including: HL7, X12, CCDA, CMS data, LOINC, SNOMED, NPI, etc.
  • Minimum of 5+ years’ experience as a Product Manager with direct experience managing the entire product development lifecycle (PDL) from concept to strategic planning to tactical activities while working with Engineering to have product input into the Software Development Life Cycle (SDLC)
  • Primary product management experience with a commercial software company serving health plans and risk bearing entities preferred
  • Proven leadership experience to manage and empower product teams while executing on product strategy and vision
  • Experience working within an Agile software development environment
  • Strong knowledge of current SaaS system architectures and technology stacks
  • Strong understanding of market, market workflows
  • Working knowledge of healthcare regulatory, privacy and security standards in a SaaS environment with the understanding of how new regulatory requirements will change product requirements
  • Demonstrated success defining and launching excellent products
  • Ability to work in a virtual, matrixed organizational structure that is fast paced, dynamic and exciting environment
  • High-energy, creatively-driven, hard-working, inspiring innovator
  • Passion for great products and a desire to delight customers
  • Strong and focused team player and a consensus builder
  • Excellent negotiation skills and ability to influence others at various levels internally and externally
  • Exceptional communication and diplomatic skills to communicate with stakeholders both inside and outside the company


  • Market knowledge
  • Customer orientation
  • Design thinking
  • Demonstrated ability to translate concepts into specific requirements/actions
  • Action orientation / effective problem solving
  • Effective team player who can work across functions





It’s not all about what we do. It’s as much about how we do it. Medecision team members show up. We consistently exemplify our 6 core values of success:

  • Execution. Service – We deliver “standing ovation” service. Speed – We are Agile. Ownership— We all take ownership and responsibility for how we deliver our promises, how we spend money, who we hire, what we build and how we help one another grow.
  • Passion. We show an infectious emotional commitment to our work because what we do is important to our customers, one another and ourselves.
  • Partnership. We are all in this together, without boundaries. Our internal/external network contains the solutions we need: we’ll continuously seek them out, use them and improve them.
  • Leadership. We are Medecision’s brand. We are experts in care management, care coordination and healthcare information and technology. We lead our clients to excellent results by providing our expertise on best practices, industry trends, solutions development and innovations. We are moving in sync with an evolving industry. There is no problem we cannot solve.
  • Innovation. We are in a constant state of discovery, inventiveness, thinking outside the box, and leading others internally and externally to do the same.
  • Candor. Medecision communicates in a sincere, direct and famil­iar way. We address conflict directly and escalate issues internally and externally to address conflict with speed and partnership.

Join us in our quest to liberate healthcare!


This description has been designed to indicate the general nature and level of work performed by an employee within this position. The actual duties, responsibilities and qualifications may vary based on assignment. Medecision is an Equal Opportunity Employer (EOE) and strongly supports diversity in the workplace.


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