Health Insurance Subject Matter Expert (Fully Remote)

3 weeks, 6 days ago
Full-time
Lead
Product Management
CoverGo

CoverGo

CoverGo offers a modular, no-code insurance platform that enables insurance providers to efficiently build, launch, and manage products across health, life, and property & casualty sectors.

Insurance
51-250
Founded 2016
$18M raised

Description

  • Support the product team through the full feature development lifecycle with health insurance domain expertise and operational insight.
  • Translate end-to-end health insurance processes such as underwriting, policy administration, claims, renewals, and billing into product requirements and functional documentation.
  • Validate and define business rules, decision engines, and workflow logic to ensure outputs are accurate, compliant, and usable in real-world scenarios.
  • Participate in User Acceptance Testing (UAT) to validate functionality, workflows, and business logic.
  • Design automation rules, decisioning frameworks, and exception handling flows to maximize Straight-Through Processing and reduce manual work.
  • Ensure product workflows reflect real insurance operations and support efficiency, scalability, and compliance.
  • Translate regulatory and policy requirements into system logic and product features.
  • Conduct market and competitor research to identify feature gaps, best practices, and emerging trends in global health insurance.
  • Act as the bridge between Product, Engineering, and Business teams to translate business needs into technical execution.
  • Contribute to roadmap discussions and prioritization from a health insurance perspective and support GTM, sales, and pre-sales efforts when needed.

Requirements

  • 12+ years of experience in the insurance industry with strong exposure to end-to-end insurance operations.
  • At least 5 years of hands-on experience in health insurance with deep knowledge of the full health insurance lifecycle.
  • Experience across 2 or more health insurance functions such as product setup, underwriting, pricing, policy administration, endorsements, billing, claims, or renewals.
  • Experience working cross-functionally with product, technology, and business teams in a fast-paced environment.
  • Hands-on, results-oriented approach with the ability to translate domain knowledge into product features.
  • Strong systems-thinking ability with an understanding of how processes connect and how rules translate into logic.
  • Critical, analytical, forward-thinking, and innovative mindset with the ability to identify gaps and propose solutions.
  • Strong verbal and written communication skills for both technical and non-technical audiences.
  • Demonstrated client-facing capability to work confidently with clients and stakeholders.
  • Nice to have: experience with life and/or P&C insurance, CII Certificate in Insurance or equivalent, digital transformation or insurance systems exposure, insurtech SME/consultant experience, and exposure to multiple markets or global health insurance products.

Benefits

  • 100% remote work.
  • Flexible leave.
  • Competitive remuneration package.
  • Performance bonus.
  • Company activities and events.
  • Learning and development plan.
  • Remote work allowance.
  • International work environment.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

Network Provider Relations & Provider Data Specialist

Evry Health 11-50 Insurance

Evry Health is seeking a remote Network Relations Specialist to manage provider network contracts, adequacy, and quality for its health plan, with a primary focus on geographic coverage in Texas metro areas.

Salesforce
1 hour, 14 minutes ago

Tech Business Specialist | Pix

Inter 51-250 Banks

Inter is hiring an engineering professional for its Core Pix team to work in a mission-critical financial environment focused on improving product clarity, operational resilience, and regulatory alignment.

GitLab Grafana JIRA Kafka Kubernetes Microservices New Relic PostgreSQL Postman SQL Server
1 hour, 42 minutes ago

Staff Business Systems Analyst, People Systems

OURA 251-1K Health Care Providers & Services

Oura is hiring a Staff Business Systems Analyst, People Systems to lead HR technology strategy and delivery across core people platforms, improving employee experiences, HR operations, and data quality.

Confluence
1 hour, 42 minutes ago

Business Systems Analyst

Mitratech 1K-5K Professional Services

Mitratech is seeking a Business Systems Analyst to bridge internal stakeholders and development teams on analytics, business intelligence, and reporting initiatives by turning business needs into clear requirements that can be delivered efficiently.

Agile Confluence JIRA
2 hours, 12 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers