Product SME - Referral Management and Patient Access at Jobgether

, , United States -

Full Time

Start Date

Immediate

Expiry Date

06 Feb, 26

Salary

125000.0

Posted On

08 Nov, 25

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare Operations, Referral Management, Patient Access, Eligibility Verification, Benefit Estimation, Authorization Management, Process Mapping, Client Advisory, Implementation Experience, Interoperability Standards, Data Exchange Workflows, Analytical Skills, Communication Skills, Problem-Solving Skills, Attention to Detail, Stakeholder Management

Industry

Internet Marketplace Platforms

Description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Product SME – Referral Management and Patient Access in United States. As a Product Subject Matter Expert, you will act as a key liaison between healthcare operations, payer systems, and technology implementation teams. Your mission is to guide clients through the digital transformation of their referral management and patient access workflows—covering eligibility, benefits, prior authorization, and coverage verification. You’ll design best-practice solutions, lead client advisory engagements, and drive measurable improvements in efficiency, compliance, and patient experience. This position involves 50% travel across the U.S. and offers the opportunity to influence how healthcare organizations optimize their access and referral management strategies through innovative product adoption. Accountabilities: Partner with client stakeholders across clinical, financial, and IT functions to assess current referral and patient access workflows. Conduct gap analyses and create detailed process maps outlining current versus future-state solutions. Design and recommend optimal product configurations aligned with client goals and operational needs. Translate business and payer requirements into clear functional specifications for implementation teams. Maintain deep expertise in referral management, eligibility verification, benefit estimation, and authorization management capabilities. Support testing phases, including UAT, and validate readiness before deployment. Provide training, enablement materials, and advisory support to clients and internal teams. Collaborate with product, implementation, and sales teams to align client insights with product roadmaps and ensure solution consistency. Drive continuous improvement through post-implementation optimization recommendations. Minimum of 8 years of experience in healthcare operations, consulting, or technology—focused on referral management, patient access, eligibility/benefits, or prior authorization. Proven implementation experience with systems such as Epic, Cerner, Experian, Availity, or similar healthcare platforms. Strong understanding of payer transactions (X12 270/271, 278), interoperability standards (HL7, FHIR), and data exchange workflows. Bachelor’s degree in Healthcare Administration, Informatics, Computer Science, Information Technology, or related field (Master’s preferred). Excellent analytical, communication, and problem-solving skills with strong attention to detail. Ability to manage multiple priorities and influence stakeholders across complex organizations. Willingness to travel up to 50% across the United States. Competitive annual salary ranging from $90,000 to $125,000, based on experience and location. Comprehensive healthcare coverage, including medical, dental, and vision insurance. 401(k) retirement plan with employer match. Generous paid time off and holiday schedule. Remote work flexibility within the U.S. and travel reimbursement for on-site client engagements. Professional development opportunities and continued learning support. Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching. When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly. 🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements. 📊 It compares your profile to the job’s core requirements and past success factors to determine your match score. 🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role. 🧠 When necessary, our human team may conduct an additional manual review to ensure no strong profile is overlooked. The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team. Thank you for your interest! #LI-CL1

Responsibilities

Act as a key liaison between healthcare operations, payer systems, and technology implementation teams. Guide clients through the digital transformation of their referral management and patient access workflows.