About Valene Health

Valene Health is building an AI-native clinical automation platform for healthcare organizations. Our agentic AI workforce helps care teams automate repetitive clinical and administrative workflows, including patient communication, documentation support, scheduling coordination, post-discharge follow-up, prior authorization, referrals, and revenue-cycle operations.

We work with health systems, physician groups, specialty practices, FQHCs, CCBHCs, MSOs, and risk-bearing organizations to reduce administrative burden, improve operational efficiency, and expand patient access.

Role Overview

We are looking for a contract-based product advisor / subject matter expert with hands-on experience in prior authorization, referral management, and revenue cycle management (RCM) workflows.

This person will work closely with Valene’s product and engineering teams to help define workflow requirements, identify edge cases, translate operational processes into product features, and support the development of our product roadmap.

This is a strong fit for someone who has worked in healthcare operations, practice management, payer/provider workflows, RCM operations, or healthtech product implementation and understands how these workflows function in real-world clinical settings.

Key Responsibilities

• Advise the product and engineering teams on prior authorization, referral, and RCM workflows.
• Help map end-to-end operational workflows, including intake, documentation, payer requirements, submission, follow-up, denial handling, and escalation.
• Identify common bottlenecks, exceptions, and failure points in current administrative workflows.
• Define product requirements for AI-supported workflow automation.
• Help prioritize roadmap features based on operational impact, customer value, and implementation feasibility.
• Review product designs, workflow diagrams, prompts, and automation logic for accuracy.
• Support QA/testing by creating realistic scenarios and reviewing product outputs.
• Help the team understand payer/provider communication patterns, documentation needs, and compliance considerations.
• Provide feedback on how Valene’s AI agents should support staff, patients, and clinical teams without disrupting existing workflows.

Areas of Expertise

• Prior authorization workflows
• Referral management and referral coordination
• Insurance verification and eligibility checks
• Denial management
• Claims follow-up
• RCM operations
• Care coordination workflows
• Specialty practice operations
• FQHC / CCBHC / physician group operations
• EMR / practice management system workflows
• Payer-provider communication processes

Qualifications

• 3+ years of experience in healthcare operations, RCM, referral coordination, prior authorization, payer operations, clinical operations, or related areas.
• Strong understanding of real-world administrative workflows in provider organizations.
• Ability to translate operational knowledge into product requirements and workflow logic.
• Comfortable working with product managers, engineers, and clinical stakeholders.
• Strong communication skills and attention to detail.
• Ability to work independently in a fast-moving startup environment.
• Contract-based availability, ideally 5-15 hours per week.

Preferred Experience

• Experience working with specialty practices, behavioral health, FQHCs, CCBHCs, MSOs, ACOs, or health systems.
• Experience with EMRs or practice management systems such as Epic, Athena, eClinicalWorks, NextGen, AdvancedMD, or similar platforms.
• Prior experience supporting product development, implementation, or workflow automation.
• Familiarity with AI, automation, or digital health tools is a plus but not required.

What Success Looks Like

• Clear workflow maps for prior authorization, referral, and RCM use cases.
• Practical feature requirements the engineering team can build against.
• Identification of edge cases and exceptions before development.
• Improved product roadmap clarity for administrative automation.
• Strong collaboration with product, clinical, and engineering teams.

Engagement Structure

• Contract role
• Estimated 5-15 hours per week
• Remote
• Hourly or project-based compensation, based on experience
• Potential to expand scope as product needs grow