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 - $164,800.00CareSource 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):
SalaryOrganization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
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What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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