Technical Product Manager, CMS Interoperability and EMR Integrations at MPower Plus

Job Title: Technical Product Manager, CMS Interoperability and EMR Integrations

Role Overview:

We are seeking a driven Technical Product Manager to own the technical vision, strategy, and execution for our CMS Interoperability and EMR Integrations teams. You will be the bridge between our business objectives and our engineering teams, ensuring we build scalable, reliable, and market-leading technical solutions following federal and state regulatory requirements using the HL7 FHIR implementation guides.

Responsibilities:

• Strategy & Vision: Assist management in defining the product vision, strategy, and roadmap, aligning with overall business goals and regulatory compliance deadlines.

• Regulatory analysis and interpretation: Strong understanding of CMS Interoperability and Prior Authorization regulations, including CMS-0057-F and its impact on payers and providers. Analyze and interpret the CMS-0057-F rule and related FHIR Implementation Guides (IGs), such as CARIN BB, US Core, Da Vinci PDEX, and Da Vinci CRD, DTR, and PAS, to translate complex regulatory requirements into detailed technical specifications.

• Requirements gathering: Collaborate with product managers, product owners, operational, and technical stakeholders to define the business and data requirements for implementing new FHIR-based APIs and updating existing ones.

• Cross-Functional Leadership: Collaborate closely with Engineering, Design, UHC/Optum Business Units and Operations to ensure successful development, launch, and adoption.

• Technical Expertise: Provide technical guidance, review architectural decisions, and ensure solutions meet the regulatory requirements.

• Privacy and Security Standards: Knowledge of data privacy and security regulations, such as HIPAA, to handle sensitive patient information during data exchange.

• Interoperability standards: Subject matter expert with related healthcare standards such as HL7 v2, CCDA, USCDI, and clinical terminology like SNOMED, LOINC, CPT, etc.

• Documentation and reporting: Develop comprehensive documentation, including data flow diagrams, FHIR API specifications, and test results. Assist in generating the CMS Interoperability Patient Access API and prior authorization metrics required for public reporting to CMS.

• Stakeholder engagement: Provide technical guidance and education on HL7 FHIR standards to business and technology teams to drive adoption and alignment with CMS requirements.

• Agile Execution: Drive the product development lifecycle using Agile methodologies (Scrum/Kanban), managing sprints, backlogs, and releases.

• Soft skills: Strong analytical, problem-solving, and collaboration skills, with meticulous attention to detail.