Division: Medical Enterprise System Modernization Division (MESMD), Behavioral Health Transformation Project (BHT)
Department: California Department of Health Care Services (DHCS) Must work on shore in the US. We cannot sponsor or transfer an H1B Visa for this role. About the Behavioral Health Transformation (BHT) Initiative
California’s behavioral health system is undergoing one of the most significant transformations in its history. Driven by new legislation—including the Behavioral Health Services Act and related reforms—DHCS is working to modernize how behavioral health services are delivered, tracked, and improved across the state.
The BHT initiative is a multi-year effort to re-architect the way DHCS partners with counties and providers to deliver care, measure outcomes, and produce transparency, and accountability. This work requires a new generation of digital tools, data infrastructure, and service delivery models. At its core, BHT is about making real changes in the lives of Californians—ensuring every dollar spent can be tied to improved access, quality, and health outcomes.
We are seeking a strong, multidisciplinary, Principal Product Manager to drive the modernization of our claims and encounter capabilities supporting Behavioral Health Transformation (BHT).
While DHCS receives claims and encounter submissions today, the systems are fragmented and lack transparency for counties, providers, and managed care plans. We are building user-facing operational software that enables submitting entities to directly manage submission quality, reconciliation status, and reporting accuracy — and to be accountable for the integrity of their data.
This role requires deep, hands-on experience owning Medicaid claims and encounter systems. The ideal candidate understands adjudication workflows, CMS reporting requirements, healthcare interoperability standards, and how operational systems drive accountability.
Statement for Speridian Technology
Speridian Technology is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Reasonable accommodations are available for qualified individuals with disabilities during the application process.
This is a senior individual contributor role operating and owning outcomes at the intersection of policy, operations, data standards, compliance, and engineering.
What You’ll Do
- Translate the strategic requirements for BHT operational systems into an executable roadmap aligned to statutory deadlines.
- Own roadmap prioritization, epics, and user stories and ensure adherence to all technical delivery standards.
- Work directly with operations and data policy teams to transform state and federal financial and accountability reporting obligations into clear, implementable product requirements.
- Own the modernization and user experience of external-facing claims and encounters management software enabling submission, validation, reconciliation, transparency, accountability and compliance.
- Design user workflows that improve data quality at the source and give counties, providers, managed care plans, and DHCS visibility into submission status, data quality, state and federal compliance.
- Coordinate and drive the development of enterprise business process maps, data models, and technical architecture with policy, data, and engineering partners.
- Ensure claims and encounter systems integrate seamlessly with Medical Enterprise Systems.
- Define measurable outcomes tied to compliance, timeliness, reconciliation accuracy, and operational performance
Required Experience
Candidates must demonstrate:
- 10+ years of product management experience in healthcare technology
- Direct ownership of Medicaid or government healthcare claims and/or encounter systems
- Deep understanding of:
- Claims adjudication workflows
- Managed care encounter reporting
- CMS Medicaid reporting requirements
- CPT/HCPCS/ICD coding structures
- Substantial experience with healthcare data standards, including:
- USCDI
- HL7 / FHIR APIs
- Standard code sets and validation frameworks
- Experience translating regulatory and reporting requirements into system functionality
- Experience operating within California state reporting environments strongly preferred
- Experience modernizing or consolidating fragmented claims or encounter systems
- Experience building submission engines, validation services, or transaction gateways
- Familiarity with MITA and Medicaid Enterprise modernization
- Experience enabling user-facing operational tools that improve data quality and compliance
- Experience working in complex public-sector or managed care environments
What Success Looks Like
- Submitting entities have clear visibility into claims and encounter status and data quality
- Validation and reconciliation workflows are transparent and standardized
- Data quality improves at the point of submission rather than through downstream correction
- Claims and encounter capabilities integrate cleanly with other DHCS operational systems
- Operational accountability across delivery systems measurably increases
Why This Role Matters
Claims and encounter systems are foundational to Medi-Cal oversight, reporting, and payment integrity. Modernizing these capabilities enables transparency, improves data quality at the source, and strengthens accountability across California’s behavioral health delivery system.
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What We Do
Speridian is an innovative, thought-leading digital modernization company that leverages modern software engineering and proprietary platform solutions to streamline and enhance interactions between clients and constituents within commercial and public sector markets. As a global business and technology solutions provider, Speridian's business and technology experts help clients modernize their businesses through Digital Transformation. Headquartered in Albuquerque, NM, with regional offices in the Americas, Middle East, Singapore, India, Pakistan, and Philippines; Speridian has been at the forefront of CRM, ERP, HR, CX innovation since 2003. Our Next-Gen Solutions Practice combined with our partnerships with leading innovators such as Oracle, Microsoft, Salesforce, Google, Amazon, UiPath, Adobe, SAP etc has led to our proven track record of solving the most pressing business problems with our unique, industry-based 3-pillar approach: (1) business focus, 2) technology-fuelled innovation, and 3) delivery excellence. Speridian’s services include consulting, testing and quality assurance, custom development, cloud computing, IT support and managed services, AI and machine learning, system integration, big data and analytics, customer experience solutions, application modernization, and staffing professional services. Based on the rich domain expertise that Speridian acquired over the years, Speridian developed several advanced platforms, enhancing their service offerings: CaseXellence, a low-code intelligent process automation platform, is designed for public sector enterprises. It modernizes legacy infrastructure and includes pre-built solutions focused on security, transparency, and traceability. Beacon, another of Speridian’s innovations, is a comprehensive suite of banking solutions. It offers a range of products including Core Banking, Loan Management, and Banking Analytics, catering to over 200 financial institutions. Finally, Speridian O360 is an Enterprise management platform providing a 360-degree view of core HR and Project Management processes. Tailored for small to medium-sized organizations, it aims to boost productivity by automating manual tasks, allowing HR to focus on strategic and critical business tasks.
