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Director, Product Management (TPA Strategy and Partner Enablement)

Remote, USA

About Lantern

Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. 

About You:

  • You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. 
  • INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with.
  • You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. 
  • You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren’t just the individuals using your product. They are the driving factor in your motivation to make a change.
  • Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. 
  • You thrive in a Team Environment. Collaboration is key in innovation and creating change.

These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. 

 

If this sounds like you, we would love to connect to speak further about career opportunities at Lantern.

Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process.

 

Lantern is focused on giving access to quality and affordable healthcare for our members. We understand and have experienced the challenges of navigating specialized healthcare, and we are dedicated to making a change.

We partner with large self-funded employers to create a benefit program for specialized care. We connect with high-quality providers to give our members peace of mind when going into surgery. And we support our members by helping them navigate the tricky aspects of healthcare; whether that be selecting a doctor, scheduling appointments, or following up after a procedure has been completed to make sure our members are feeling better.

Job Overview

The Product Director - TPA Strategy and partner enablement is responsible for the growth strategy and roadmap of our TPA and core financial platforms. This includes transactional workflows like member enrollment, benefits validation, accumulator mgmt., provider experiences, claims and payment lifecycle, invoicing, reporting and analytics.  The role will drive has three key charges: 1) Craft a growth strategy for our  Intelligent TPA platform and core workflows around claims, payments, billing, benefit mgmt. etc. that will power Lantern’s 3-5 year growth by leveraging your domain expertise, internal operations and commercial SME, as well as industry best practices and tools, 2) build a roadmap to build next generation platform capabilities and  Data Exchange frameworks (API, EDI, and Batch) including ingestion, mapping, translation, validations, overall data management  and governance to support TPA workflows and 3) Enable specific data exchanges with health plans, partners, providers, data brokers, clearing houses etc. that drive our member, provider, and client/partner operations.

The TPA director is a hands-on role, to build and execute product strategy while providing exemplary leadership, mentorship and guidance to the teams. This role will help shape and evolve the TPA Processes product function towards better processes, tooling, and execution as we aim to continuously improve our craft.

Build and manage Lantern’s Interoperability and data products serving both internal and external stakeholders. Key areas of ownership include: 

  • Leadership: Build and mentor high performing agile teams driving best in class execution and delivery of high-quality products. Manage and Mentor product managers.
  • Discovery: Perform deep discovery and user research with stakeholders, members, internal users, while considering legal, regulatory and competitive market dynamics. Bring qualitative and quantitative insights to the table for discussion. 
  • Strategy: Craft and drive the TPA product strategy coupling an extensible backend platform and interoperability capabilities with world class user experience. Collaborate with relevant stakeholders, including presenting to and working with senior leadership. 
  • Roadmap: create, align, and provide cross org visibility to TPA Data roadmaps. This role is both responsible and accountable for all work that happens around internal and external data exchanges. 
  • Alignment: create top down and bottom-up alignment ensuring your direct, peers, teams, and senior leadership are providing the right level of guidance in accordance with RACI or similar. 
  • Experimentation: Set the bar for when and where to experiment. Bring a data-driven approach to building products but leverage your experience and product sense to deliver the right products on time and within budget. Perform rapid experimentation where needed, test manually, build stat sig experiments that prove and disprove our hypothesis  
  • Approach: Apply product led growth concepts, letting our users (internal/external) shape our Analyze existing products, make the tough calls, say no, and create pitches and actionable plans for implementing new features. Make smart decisions applying 1 vs. 2-way door framework  
  • Process: Refine and build enterprise platform tooling and capabilities and high-quality products on time and in budget while ensuring visibility and alignment across the org Manage the product development process and timeline to ensure targets are met on time and in budget for:
    • Enrollment, Eligibility, Accumulators, and Benefits Validation: We ingest member enrollment data from client TPA, partners and benefit administrators at multiple times in the Case journey, we validate the member’s benefits, accumulators, and cost share.
    • Claims processing: We process claims for services provided to our members by our network provider.
    • Data and systems: we ingest multiple data sources – eligibility, claims, prior authorization, payments feeds to drive our systems. We need standards and rules to reduce operational overhead and increase simplicity in our service offerings. 
    • Internal tools and systems: we have several internal tools and systems that service different parts of the business and need to be integrated, for example identifying and credentialing provider / facility targets etc.
    • Activations/insights: leverage key data and insights around Data exchanges like audit trail, error handling, monitoring, performance SLAs etc.
    • Health Plan and Partnership Integrations: Be an Advocate and Support the member experience in conjunction with relevant integrations through health plans and digital health partners 
    • Reporting: Create scalable, accurate, differentiated internal and external reporting 
      • Internal: Executive Dashboards/ KPI visualization 
      • External: Client and Partner Reporting as a Product 

Qualifications 

  • 15+ years’ experience in Product Management, Healthcare Data Managment, Claims and TPA workflows or related fields
  • 10+ years in building enterprise health tech platform in relevant specialty (TPA, Claims, Payments and X12 data exchanges, technical services etc.) 
  • Relevant Healthcare or HealthTech experience essential
  • Proven product leadership track record and people management experience highly desired
  • Bachelor’s degree required 
  • Experience with startup/growth phase company
  • Collaborating with both US and offshore teams
  • Experience with Agile Scrum Methodology 
  • Ability to travel up to 1-2x/quarter

 

Benefits:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Short- & Long-Term Disability
  • Life Insurance
  • 401k with company match
  • Flexible Paid Time Off
  • Paid Parental Leave

 

Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.

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