EDI Technical Product Manager

Job Summary:

The EDI Technical Product Manager serves as the strategic and technical owner of CareSource's EDI platform, responsible for driving the vision, roadmap, and execution of enterprise data exchange capabilities. This role combines a deep understanding of healthcare EDI standards with strong product management and technical skills to deliver scalable, reliable, and regulatory-compliant integration solutions. The EDI Technical Product Manager partners with engineering, architecture, operations, and business stakeholders to ensure EDI products support organizational objectives, reduce friction for trading partners, and improve end-to-end data quality.

Essential Functions:

• Define and evolve the EDI product vision, strategy, and long-term roadmap in alignment with enterprise architecture, regulatory mandates, and CareSource’s operational priorities.
• Create business cases, success metrics, and ROI analyses to guide prioritization and investment decisions.
• Stay current on industry trends, CMS/state requirements, and interoperability standards (X12, APIs, FHIR) to shape the future-state EDI landscape.
• Translate complex business, regulatory, and integration requirements into clear, actionable user stories and technical specifications for engineering teams.
• Ensuring requirements encompass data mapping, validation business rules, error handling flows, and integration points across downstream systems.
• Collaborate closely with architecture, engineering, QA, and DevOps to guide solution design, ensure technical feasibility, and support high-quality deployment.
• Own and prioritize the EDI product backlog based on technical dependencies, stakeholder value, operational impact, and compliance needs.
• Drive sprint planning, feature readiness, and release coordination to support predictable and transparent delivery.
• Identify and remove impediments that impact engineering throughput or trading partner readiness.
• Act as a bridge between technical teams, trading partners, clearing houses, and internal business units to ensure alignment and clarity of expectations.
• Lead discovery sessions, refinement cycles, data exchange walkthroughs, and post-implementation assessments.
• Advocate for partner usability and operational efficiency through system improvements, automation, and enhanced monitoring capabilities.
• Analyze transaction performance, defect trends, operational SLAs, and platform telemetry to identify risks, bottlenecks, and optimization opportunities.
• Define and track KPIs/OKRs such as transaction throughput, first-pass acceptance rate, error volume, partner onboarding speed, and system reliability.
• Collaborate with engineering to drive continuous improvement in observability, error reconciliation, and data integrity.
• Establish and maintain comprehensive product documentation, functional requirements, user guides, and integration specifications.
• Contribute to technical standards, EDI governance frameworks, and best practices for onboarding, testing, and release coordination.
• Ensure solutions comply with HIPAA, state Medicaid requirements, data privacy standards, and CareSource security guidelines.
• Perform any other job related duties as requested.

Education and Experience:

• Bachelor's degree in computer science or related field required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Five (5) years of experience in product management or related field required

Competencies, Knowledge and Skills:

• Strong understanding of EDI technologies and integration platforms
• Familiarity with Agile methodologies and product development life cycles
• Skilled in software development or engineering
• Understanding of the Healthcare industry and ecosystem including future direction. In-depth knowledge of interoperability standards relevant to the industry
• Strong verbal and written communication skills are essential for articulating product vision and collaborating with stakeholders
• Strong analytical and problem-solving skills to assess performance and identify areas for improvement
• Ability to adapt to rapidly changing technologies and market conditions
• A mindset geared toward innovation, continuously seeking new ways to enhance capabilities and interoperability
• Knowledge of AI technologies, machine learning models, and ethical considerations in AI deployment

Licensure and Certification:

• Certifications in core technical systems such as Edifecs, Facets, Cloud, AI, or other similar enterprise systems that CareSource invests in are preferred
• Certifications in Agile, SAFE, or in the Business or Product Owner role are preferred

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required

Compensation Range:

$94,100.00 - $164,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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Brand=CareSource