Product SME – Referral Management and Patient Access at IKS Health

About  IKS Health  www.ikshealth.com

IKS Health takes on the chores of healthcare, reducing administrative, clinical, and operational burdens so that staff can focus on their core purpose: delivering exceptional care. Combining pragmatic technology and dedicated experts, IKS enables stronger, financially sustainable enterprises. Our Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality, and achieve cost savings through forward-thinking solutions. Founded in 2006, IKS Health’s global workforce supports large health systems across the United States.

Role Overview

50% travel will be required

The Product SME – Referral Management & Patient Access is a techno-functional expert who bridges healthcare operations, payer logic, and technology implementation. This role ensures clients successfully transition their referral and patient access workflows — including eligibility, benefits, prior authorization, and coverage — into our product ecosystem.

The SME will provide strategic guidance, design best-practice solutions, and drive measurable value realization for customers through effective adoption and optimization of our platform.

Core Responsibilities

Client Process Assessment & Mapping

Engage with client stakeholders across clinical, financial, and IT functions to understand current referral and access workflows.

Conduct detailed gap analyses between the client’s current systems and the target environment.

Map existing processes such as referral routing, eligibility verification, prior authorization, and patient liability estimation to product capabilities.

Solution Design & Advisory

Recommend best-practice configurations and workflows based on client goals and constraints.

Define functional architectures and create solution blueprints showing how requirements are met within the product.

Provide advisory support to improve operational efficiency, compliance, and patient experience.

Requirements Translation & Validation

Translate business and payer requirements into clear functional specifications for implementation teams.

Validate configurations and integrations to ensure alignment with solution design.

Represent both the “voice of the product” and the “voice of the customer” throughout implementation.

Product Expertise & Enablement

Maintain deep knowledge of product capabilities related to referral management, coverage verification, benefit estimation, and authorization management.

Serve as an internal and external subject matter expert, supporting pre-sales, implementation, and customer success teams.

Provide training and enablement materials for complex product features.

Customer Guidance & Change Management

Help clients visualize the end-state solution and understand its business impact.

Partner with change management teams to support user adoption and process redesign.

Advise on continuous improvement opportunities post-go-live.

Collaboration & Alignment

Partner closely with Product Managers to share client insights and feature feedback.

Work with Functional Implementation and Integration teams to ensure consistency across configurations.

Support Sales and Pre-Sales teams by articulating product value and solution feasibility.

Quality Assurance & Acceptance

Review testing outcomes and validate use-case coverage before go-live.
Support User Acceptance Testing (UAT) and sign off on functional readiness from a product perspective.

Key Deliverables

Current vs. future-state process maps

Functional and solution design blueprints

Gap analyses and feasibility assessments

Product usage and enablement documentation

Client advisory and training materials

Post-implementation optimization recommendations

Key Skills & Attributes

Exceptional detail orientation and analytical rigor

Strong critical thinking and problem-solving ability

Excellent project management and organizational skills

Ability to influence, inspire, and lead through ambiguity

Mathematical and financial savvy to assess economic impact

Diligence, accountability, and follow-through

Excellent communication, stakeholder management, and facilitation skills

Comfortable working in a dynamic, fast-paced environment

Qualifications

Experience: 8+ years in healthcare operations, technology, or consulting, focusing on referral management, patient access, eligibility/benefits, or prior authorization.

Implementation Expertise: Hands-on experience implementing or configuring solutions such as Epic, Cerner, Experian, Availity, or similar.

Technical Acumen: Familiarity with payer transactions (X12 270/271, 278), interoperability standards (HL7, FHIR), and healthcare data exchange processes.

Education:

Bachelor’s degree in Healthcare Administration, Informatics, Computer Science, or related field (Master’s preferred).

Compensation and Benefits: The base salary range for this position is $ $90,000-$125,000 a year. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. IKS Health offers a competitive benefits package, including healthcare, 401 (k), and paid time off (all benefits are subject to eligibility requirements for full-time employees). IKS Health is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.