Vice President, Product, Medical Cost Containment & Authorization

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change. At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission. We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding. Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem. We are seeking a Vice President of Product, Medical Cost Containment & Authorization to lead the strategy, execution, and scale of our Utilization Management (UM) product portfolio during a pivotal moment of industry transformation. This VP will own an end to end product suite that blends AI driven decisioning, healthcare interoperability, and deep UM expertise, with a mandate to modernize and disrupt how utilization management is delivered across the healthcare ecosystem. This is a high impact, executive level role for a product leader who thrives in ambiguity, can operate as a peer to senior executives, and has the confidence to lead through scale, complexity, and change. Sponsorship, in any form, is not available for this position. Location: Remote, US 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: • Bachelor s degree required; advanced degree (MBA, MHA, MPH, RN, MD) strongly preferred. • 10+ years of experience in healthcare product management, medical management, or utilization management. • 5+ years in a senior product leadership role. • Deep expertise in prior authorization, utilization review, and medical cost containment strategies. • Strong understanding of managed care, payer operations, and healthcare regulations. • Experience working with clinical teams and medical policy development. • Background in digital health, automation, or AI-enabled clinical workflows. • Proven success launching complex, regulated healthcare products at scale. • Strategic product leadership and executive-level communication. • Ability to translate clinical and regulatory complexity into usable products. • Strong analytical and financial acumen. • Collaborative leadership across clinical, technical, and business teams. • Comfort operating in highly regulated, fast-changing environments. You will set yourself apart: • Proven track record in building AI products from incubation to scale • Experience disrupting an established healthcare workflow You will be: Product Strategy & Vision • Defining and owning the long-term product vision and roadmap for medical cost containment and authorization capabilities. • Aligning product strategy with enterprise affordability, quality, and growth goals • Identifying market trends, regulatory changes, and competitive. opportunities impacting utilization management and authorization. Product Development & Lifecycle Management • Leading the end-to-end product lifecycle from concept through launch, optimization, and sunset. • Translating clinical, operational, and regulatory requirements into clear product requirements and prioritization. • Partnering with engineering and data teams to deliver scalable, configurable authorization and cost containment solutions. • Ensuring products support evidence-based medicine, medical policy, and evolving clinical guidelines. Medical Cost Containment & Authorization • Overseeing products supporting prior authorization, concurrent review, retrospective review, and specialty management. • Driving innovation in automation, rules engines, AI-assisted review, and straight-through processing. • Balancing cost containment objectives with access to care, provider experience, and member satisfaction. Cross-Functional Leadership • Collaborating with stakeh...