UM Product Operations Analyst

UM Product Operations Analyst

This role sits at the intersection of healthcare operations, product support, and AI innovation, contributing to the modernization of utilization management and prior authorization workflows. You will help ensure clinical and payer data is accurately structured, validated, and operationalized within an AI-enabled platform designed to improve healthcare efficiency. The position combines hands-on analytical work, software testing, and cross-functional collaboration with clinical, product, and engineering teams. A key focus is supporting AI/NLP capabilities by validating model outputs and contributing to annotation and test case development. You will play a critical role in ensuring regulatory compliance, data quality, and operational excellence. This is a highly collaborative and mission-driven environment where your work directly impacts patient access to care.

In this role, you will support the operational, analytical, and technical execution of a next-generation utilization management platform, ensuring data integrity, system performance, and continuous improvement across workflows.

• Manage payer and clinical data processing, ensuring accurate ingestion, mapping, and system integration within internal platforms.
• Design, execute, and maintain test plans and test cases for software features and AI/NLP functionalities, ensuring reliability and clinical accuracy.
• Identify, document, and track defects using bug tracking systems while supporting data validation and quality audits.
• Contribute to AI model evaluation by validating NLP outputs, developing annotation guidelines, and improving model performance through structured feedback.
• Support utilization management workflows, including account review, compliance monitoring, and production goal tracking.
• Collaborate with cross-functional teams (clinical, engineering, product, data science) to support roadmap execution and process optimization.
• Drive operational improvements by identifying inefficiencies and recommending scalable workflow enhancements.

Requirements

• Experience in healthcare, utilization management, or a related clinical/healthtech environment preferred (degree or equivalent experience accepted).
• Familiarity with healthcare terminology, CPT/ICD-10 coding, and payer programs such as Medicare/Medicaid is highly desirable.
• Experience in software testing, QA processes, or test case development; exposure to AI/NLP annotation or model testing is a plus.
• Advanced proficiency in Excel and strong overall computer literacy (Microsoft Office Suite).
• Ability to analyze complex data sets, identify issues, and communicate findings clearly to technical and non-technical stakeholders.
• Strong organizational skills with the ability to manage multiple priorities and work independently with minimal supervision.
• Excellent problem-solving, attention to detail, and critical thinking abilities.
• Strong communication skills and a collaborative mindset, comfortable working across multidisciplinary teams.

Benefits

• Competitive compensation package with potential bonus eligibility
• Comprehensive healthcare coverage (medical, dental, vision)
• Paid time off, holidays, and flexible work arrangements (remote within the US)
• 401(k) retirement plan with company contribution
• Professional development and education reimbursement opportunities
• Wellness support programs and employee assistance resources
• Opportunity to contribute to high-impact healthcare innovation at scale