Product Solutions Lead (Nashville)

We are looking for a Value Architect to serve as the strategic engine behind our Health Plan's growth. You will be the primary translator for our most sophisticated buyers: Commercial leaders looking for a competitive edge, Product owners managing complex lifecycles, and Finance teams focused on the bottom line. You aren’t just identifying market needs; you are building the economic and operational case for why our solution belongs in a Payer’s core portfolio.

You are the bridge between Payer’s P&L challenges and our technical capabilities. Core Responsibilities Commercial serves as the strategic engine behind our Health Plan, t alongside our Health Plan sales teams. You will participate in meetings throughout the sales process, peeling back the layers of a Payer’s objection to determine whether the root cause is Financial (actuarial risk), Commercial (market-share loss), or Operational (implementation friction).

Market-to-Product Synthesis: Act as the voice of the health plan within the internal product organization. You will synthesize market needs, objections, and trends into structured recommendations for the collective roadmap. Financial & Actuarial Advocacy: Partner with Payer Finance and Actuarial teams to build and validate the value story.

You will build business cases that demonstrate how our product impacts the cost of care, reduces administrative spending, or improves ROI for medical benefit programs. Product Lifecycle Collaboration: Work as a key stakeholder alongside our Engineering and Payer Product teams to ensure our roadmap aligns with the Payer Calendar (e.g., filing cycles, bid cycles, and open enrollment readiness). Solution Engineering (The Technical Closer): Serve as the subject matter expert in deep-dive sessions with Payer leadership.

You must be able to explain how our solution integrates with their claims engine and Digital Front Door while defending the product’s financial impact. Cross-Functional Liaison: Serve as the connective tissue between Sales, Actuarial/Legal, and Engineering to ensure that what we promise in a Payer contract is operationally sound and financially viable. Required Qualifications and Experience: 1.

Professional Experience 8–12+ Years in Health Plan Operations or Strategy: Experience specifically within Commercial Markets, Product Development, or Actuarial/Finance divisions of regional or national Payer. The Payer-Side Track Record: Proven history of managing or influencing a health plan P&L . You should have experience with how a plan is priced, filed with regulators, and sold to groups.

Cross-Functional Solutioning: Demonstrated experience sitting between The Field (Sales/Brokers) and The Build (IT/Operations) to launch a new insurance product or a high-stakes clinical program. B2B Enterprise Value Modeling: Experience building formal ROI models or Value Stories that have successfully convinced a Finance/Actuarial team to approve a new vendor or internal initiative. 2. Domain Expertise & Technical Literacy Payer Financial Mechanics: Deep fluency in MLR (Medical Loss Ratio) drivers, PMPM (Per Member Per Month) cost structures, and the Administrative Credit logic used by payers to justify technology spend.

Regulatory & Filing Knowledge: High-level understanding of the Payer Product Lifecycle , including state filing requirements (SERFF), CMS compliance, and the 12–18-month lead times required for benefit design changes. Technical Interoperability: While not a coder, you must understand how data moves in a Payer environment—specifically Claims Data (EDI 837/835) , Eligibility feeds (834), and the basics of FHIR/HL7 integration. Segment Knowledge: Ability to differentiate product needs across Commercial Fully-Insured, ASO (Self-Funded), and Medicare Advantage segments. 3.

Strategic Soft Skills Advanced Diagnostic Listening: The ability to conduct Discovery interviews with Payer stakeholders and distinguish between a technical hurdle (IT), a financial hurdle (Actuarial), and a Political hurdle (Executive). Synthesis & Narrative Building: The skill to take 50 pages of actuarial data and Market Noise and distill it into a 5-slide Value Story that a Payer VP can use to sell the solution internally. Collaborative Diplomacy: A low-ego, high-influence approach.

You'll need to advocate for market needs to the Engineering team without ordering features; instead, use data and business cases to earn priority.