Domain Operator, Payer
Platform GTM
Segment | Payer (health plans, MA, Medicaid managed care, TPAs) |
Type | Contract to hire (6-month contract, conversion to full time on performance) |
Level | 5 to 8 years of payer operating experience |
Location | United States (remote, with travel to client sites) |
Reports to | Head of Operations |
Start | [INSERT TARGET START DATE] |
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About the role
Genzeon Platforms is hiring a Domain Operator for the payer segment. You bring operating depth from inside a health plan and apply it to how our clinical operations platform is positioned, packaged, sold, and validated in payer accounts. You work alongside our Forward Deployed Engineers, product team, and cloud partner sellers, and you are the person accountable for whether the payer story holds up in front of people who have run these operations themselves.
This is an operator seat, not a traditional product management seat. We are hiring for domain authority first and product craft second.
Responsibilities
Own the payer segment narrative: discovery frameworks, demo scripts, objection handling, and ROI models credible to a Chief Medical Officer, a VP of Utilization Management, and a procurement lead.
Enable cloud partner and internal field sellers on payer qualification, use case fit, and handoff criteria.
Shape commercial packaging for the payer motion, including cloud marketplace listings, private offers, and tier structure.
Translate field requirements into prioritized product input, and defend that prioritization with evidence from real accounts.
Validate agent behavior and rule pack design with Clinical AI Architects against how payer medical policy, gold carding, and delegated UM arrangements actually work.
Own positioning for CMS-0057-F, including the January 1, 2027 electronic prior authorization requirement.
Maintain competitive ground truth on incumbent utilization management platforms and emerging AI entrants.
First 90 days
Days 1 to 30: Complete the Healthcare Brain Academy Client Engagement curriculum. Shadow production operations. Participate in at least ten customer or prospect conversations.
Days 31 to 60: Rebuild the payer discovery and demo narrative. Deliver your first partner seller enablement session.
Days 61 to 90: Own the payer segment in at least three active opportunities and deliver a written point of view on the top two product gaps affecting win rate.
Required qualifications
5 to 8 years inside a health plan, TPA, or payer services organization, in prior authorization, utilization management, medical review, payment integrity, appeals and grievances, or claims operations.
Hands-on ownership of a process or workstream: a turnaround time you were measured on, a backlog you helped clear, an audit you supported, or a process change you drove and saw adopted.
Fluency in how coverage decisions are made: medical policy, LCD and NCD, MCG or InterQual, medical necessity criteria, peer to peer review, and turnaround time mandates.
Working knowledge of the transaction layer, including X12 278, X12 270/271, and the CMS-0057-F FHIR requirements. You do not need to write code.
Working literacy in adjacent ecosystems: how a health system's referral and patient access workflow shapes what reaches your auth queue, and how specialty pharma and medtech manufacturers experience payer coverage policy.
Stakeholder credibility. You have presented to plan leadership, participated in a vendor selection, or led a change effort other teams had to adopt.
Strong written communication. Much of this role is a well argued one page memo.
Preferred qualifications
Clinical licensure (RN, LPN) or coding credential (CPC, CCS).
Experience evaluating or deploying AI in a regulated payer environment.
Familiarity with Azure and cloud marketplace transaction models, or experience in a hyperscaler co-sell motion.
Medicare Advantage or Medicaid managed care depth.
Not a fit
Candidates who have sold payer software but never operated inside a plan.
Generalist AI product managers intending to learn the domain on the job.
About Genzeon Platforms
Genzeon Platforms is building the Healthcare Brain, agentic AI decision infrastructure for healthcare. Three platforms run in production: HIP One for clinical operations, PES One for patient and member engagement, and CPS One for privacy and AI governance, all built on Aether One, a patent protected agentic substrate with 12 patents filed. We serve 50+ enterprise platform clients across payers, providers, and government, and operate under HIPAA, SOC 2 Type II, and ISO 27001. Headquartered in Exton, Pennsylvania.
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