• Lead the definition and delivery of a healthcare contract modeling platform roadmap, requirements, and product backlog.
• Translate complex payer contract language into detailed business rules, user stories, and technical specifications.
• Design and validate reimbursement modeling logic, including DRG, APC, per diem, case rate, stop-loss, outlier, and other payment methodologies.
• Partner with software engineers, architects, QA teams, and external development partners to deliver scalable product functionality.
• Support AI-powered contract extraction and automation initiatives by validating contract interpretation, establishing review processes, and defining governance standards.
• Gather customer and market requirements to enhance future capabilities such as underpayment detection, contract compliance, scenario modeling, revenue forecasting, and strategic pricing.