Product Manager, Clinical Programs & Case Management

Company : Highmark Health Job Description :  JOB SUMMARY *If you are located within a 50 mile radius of our Pittsburgh Office or Buffalo NY office this will be a hybrid role requiring in office 3 days a week (T/W/Th) The Product Manager is responsible for defining and advancing the strategy, roadmap, and performance of a portfolio of clinical programs and care management solutions that improve member outcomes, enhance the healthcare experience, and drive business value. This role serves as the primary connector between business, clinical, operational, analytic, and technology teams to identify opportunities, develop solutions, and ensure delivery of products and programs that support Highmark's Living Health strategy. The Product Manager owns the end-to-end lifecycle of assigned products and programs, from opportunity identification and business case development through launch, optimization, measurement, and ongoing portfolio management. The role requires strong healthcare domain expertise, strategic thinking, data-driven decision making, and the ability to influence cross-functional stakeholders across a complex healthcare ecosystem. This position focuses on ensuring that we are building the right products, capabilities, and member experiences to improve health outcomes, reduce avoidable costs, simplify healthcare navigation, and increase member engagement. Key Responsibilities Define product strategy, vision, and roadmaps for clinical programs, care management solutions, and supporting capabilities, ensuring alignment with business priorities and member needs. Lead products and programs through their entire lifecycle, from opportunity identification and business case development through implementation, measurement, optimization, and retirement. Partner across clinical, operational, analytics, technology, digital, and vendor teams to align priorities, drive execution, and deliver business and member outcomes. Design and evolve clinical programs, member journeys, and engagement strategies that improve health outcomes, member experience, quality performance, and affordability. Establish success measures, monitor product performance, and leverage data, analytics, and market insights to drive continuous improvement and value realization. Serve as the voice of the member, customer, and business while influencing stakeholders, managing competing priorities, and leading strategic decision-making across the portfolio.  ESSENTIAL RESPONSIBILITIES Understand the department's and the company's strategic roadmap and competitive position, and develops a holistic product vision and the corresponding product strategy to drive maximum value. Clearly set and communicate roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels. Actively anticipates future needs and utilizes metrics and qualitative input to identify asset improvement opportunities. Represent the product in all governance meetings. Clearly sets and communicates roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels. Serve as accountable owner for the sets of products/tools within the designated portfolio. Identify and drives both cross-product and cross-customer value and shared learnings. Own the product backlog and uses input from internal and partner teams to frequently refresh and re-prioritize the backlog. Other duties as assigned. EDUCATION Required Bachelor's Degree in science, technology, mathematics or related field OR relevant experience and/or education as determined by the company in lieu of bachelor’s degree Preferred None EXPERIENCE Required 3 years of Product experience To Include: 3 years with the Software Lifecycle 1 year of Advanced domain experience Preferred Experience leading cross-functional initiatives in a matrixed environment. Strong analytical, strategic planning, and business case development skills. Experience working with healthcare data, performance metrics, and outcome measurement. Excellent communication, stakeholder management, and executive presentation skills. Experience within a health plan, managed care organization, payer, provider, or population health environment. Knowledge of care management, Stars/HEDIS measures, population health, utilization management, quality programs, or value-based care. Experience supporting digital health, member experience, or clinical technology solutions. Product Management certification or Agile experience. LICENSES or CERTIFICATIONS Required None Preferred None SKILLS Business Acumen for P&Ls Communication Conflict Management Key words :  Clinical Programs, Case Management, Care Management, Population Health, Health & Wellness, Product Manager, Product Roadmap, Product Lifecycle, Business Case Development, Portfolio Management, Program Design, Health Outcomes, Member Experience, Stakeholder Management, Cross Functional Leadership, Data Driven Decision Making, Medicare Advantage, STARS/ HEDIS, ID& Strat, Risk Stratification, Health Navigation, Population Health Management, Clinical Operations, Disease Management, Transitions of Care, Quality Programs, ROI/KPI, Vendor Management, Process Optimization, Outcome Measurement, Stakeholder Management. Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required  Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Never Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this