Lead Product Manager, Claims and Eligibility

Reporting to the Senior Director of Product Management, the Lead Product Manager, Claims and Insurance Eligibility will own the development of systems and experiences that support eligibility verification, claims generation, and reimbursement. This role is part of the Care Foundations Product team and is critical to scaling our healthcare infrastructure and optimizing financial outcomes for members, Providers, and Spring.

Please note that this is a hybrid role based in New York City, with an expectation to be in office 2-3 days a week. Our office is located at 60 Madison Avenue. 

What you’ll do:

• Define and drive the product roadmap for eligibility verification, claims processing, EDI integrations, and payer reimbursement workflows.
• Partner with engineering, revenue cycle operations, data, and compliance teams to deliver reliable, accurate, and scalable systems.
• Improve real-time eligibility checks and automate claims submission processes to reduce administrative overhead.
• Ensure products meet HIPAA and other regulatory requirements while optimizing for user experience and operational efficiency.
• Identify and resolve pain points that lead to claim denials, slow reimbursements, or friction for members and providers.
• Measure and enhance the success of claims workflows through product analytics, stakeholder feedback, and A/B testing.
• Strategically leverage AI and other technologies to gain large efficiencies
• Mentor, and often supervise the work of, junior product managers that also work on revenue cycle capabilities

What success looks like:

• High level of accuracy for eligibility checks
• Lower processing cost per appointment
• 90%+ claims auto-submitted
• Significant increase in “clean claims”/reduction in claim denial rates 
• Improve revenue cycle automation to reduce manual interventions
• Deliver 90% of roadmap milestones within scope and timeline

What you’ll bring:

• 5+ years of product management experience, including experience in healthcare tech
• Experience developing and delivering on strategic roadmaps tied to longer term company objectives
• Deep familiarity with claims workflows, eligibility checks, and healthcare billing standards (e.g., EDI, X12)
• Demonstrated ability to lead cross-functional teams across operations, engineering, and compliance
• Strong technical acumen and systems thinking, especially with complex data workflows and the ability to improve them with AI and automation
• Experience using product analytics to inform priorities and drive improvements

Nice to have:

• Experience with payer-provider systems or clearinghouses
• Familiarity with Medicare, Medicaid, or commercial insurance billing nuances
• Track record of building products in a high-compliance, regulated environment

The target base salary range for this position is $182,000 - $242,880, and is part of a competitive total rewards package including equity and benefits. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually using Radford Global Compensation Databaseat minimum to ensure competitive and fair pay. 

Benefits provided by Spring Health:

Note: We have even more benefits than listed here and below, your recruiter will provide more in-depth information as you continue in the interview process. Benefits are subject to individual plan requirements and eligibility criteria.

• Health, Dental, Vision benefits start on your first day at Spring. You and your dependents also receive access to One Medicalaccounts HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type.
• Employer sponsored 401(k) match of up to 2% for retirement planning
• A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents.
• We offer competitive paid time off policies including vacation, sick leave and company holidays.
• At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents.
• Access to Noom, a weight management program—based in psychology, that’s tailored to your unique needs and goals. 
• Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses.
• Access toWellhub,  which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
• Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care
• Up to $1,000 Professional Development Reimbursement a year.
• $200 per year donation matching to support your favorite causes.