Product Manager- Claims and Provider Lead

Infosys Helix is seekingaProduct Manager- Claims and Provider Lead for this growing team. The Work stream Leader will provide leadership and operational oversight for the implementation and ongoing operations of Infosys Helix across Claims, Provider, and A&G functions for Medicare Advantage programs serving US health plans. This role will act as the primary client-facing leader, responsible for ensuring seamless delivery of all Claims, Provider, and A&G capabilities, driving regulatory and contractual compliance, and enabling scalable, efficient, and auditable operational processes across the platform.

Key Responsibilities

• Oversee end-to-end Claims, Provider, and Appeals & Grievances (A&G) operations for Medicare Advantage, ensuring accurate adjudication, pricing, payments, issue resolution, and provider data quality.
• Serve as the primary client-facing leader for all Claims, Provider, and A&G functions delivered through the Infosys Helix platform.
• Ensure CMS compliance by implementing strong operational controls, monitoring regulatory updates, and maintaining audit-ready processes across Claims, Provider, and A&G workflow areas.
• Lead provider lifecycle management including onboarding, credentialing integration, directory accuracy, network data stewardship, and coordination on provider-related A&G matters.
• Drive performance monitoring through KPIs, root-cause analysis, quality improvements, and corrective action planning across Claims, Provider, and A&G operations.
• Collaborate across Claims, Provider, Medical Management, A&G, and compliance teams to deliver a seamless Medicare Advantage operational experience.

Required Qualifications

• The candidate must be located within commuting distance ofTempe, AZor be willing to relocate to this area.This position may require travel in the US.
• Bachelor's degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of Education.
• 7 Yrs of Domain experience (Healthcare).
• 5 years of experience in US healthcare operations, including deep expertise in Medicare Advantage regulations, CMS compliance requirements, and payer operational processes.
• Strong understanding of Claims and Provider operations, including regulatory controls, audit readiness, HIPAA compliance, and BPaaS/SaaS healthcare platforms.
• Demonstrated ability to lead cross-functional teams, work with clients as a primary liaison, and influence stakeholders without direct authority.
• Excellent communication, analytical, and problem-solving skills, with the ability to translate regulatory or contractual requirements into scalable operational processes.
• Medicare Advantage Claims and Provider operation, CMS Audits.
• Strong understanding of healthcare payer operations.
• Excellent communication, presentation, and interpersonal skills
• Ability to influence cross functional teams without direct authority.
• Strong analytical and risk-based decision-making skills.

Preferred Qualifications:

• Ability to elicit information from myriad ofSMEs (technical & business).
• Ability to providethought leadership and influence to implement strategic methods.
• Excellent and assertivecommunication skills.
• Ability to switch between projects and maintain consistency.
• Ability to be a part of a diverse team/ multiple stakeholder environment.
• Working in an agile environment- with Scrum, Kanban, SAFe methodologies.
• Experience and desire to work in a Global delivery environment.

Along with competitive pay, as a full-time Infosys employee you are also eligible for the following benefits:

• Medical/Dental/Vision/Life Insurance.
• Long-term/Short-term Disability.
• Health and Dependent Care Reimbursement Accounts.
• Insurance (Accident, Critical Illness, Hospital Indemnity, Legal).
• 401(k) plan and contributions dependent on salary level.
• Paid holidays plus Paid Time Off.

The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email or face to face. Travel may be required as per the job requirements.

Client-provided location(s): Tempe, AZ

Job ID: Infosys-145202BR

Employment Type: OTHER

Posted: 2026-03-06T18:43:53