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Hire Mr. Arnold

Healthcare product leader

Remote · Raleigh, North Carolina

Andrew Arnold

I launch the platforms providers depend on — claims, enrollment, and the unglamorous EDI that actually moves money — and I still make it home for the campfire.

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Currently Product Manager, Availity

Andrew sitting by a campfire with his two children roasting marshmallows under a wooden Dad’s Camp sign, a bear peeking over the top.
Dad’s CampRule #1: Make memories. Rule #2: Eat s’mores.

500M+

X12 transactions on the Optum iEDI suite

2M+

claims corrected and resubmitted

98.9%

clean claim rate on the OTI engine

1,500

EPlus organizations in under 3 months

About

Family man. Product leader. Twenty years in the pipes of American healthcare.

The work is technical. The job is not. It is getting the right claim paid, the right estimate into a patient’s hands, and the right team pointed at the next release — without theater.

At Availity I took claims from a status mystery to a working product. At Optum I ran the Intelligent EDI suite that processed half a billion transactions. Before that I rebuilt how benefits elections became carrier files. Discovery before roadmap. Roadmap before heroics.

I lead the way I parent: calm, specific, and present. Healthcare is a human business. So is product.

Product

  • Strategy and roadmaps
  • Customer discovery
  • Backlog and pricing
  • Launches and adoption

Healthcare

  • Claims and denials
  • Benefits enrollment
  • Payer integrations
  • Clearinghouse platforms

Interoperability

  • X12 EDI
  • REST APIs
  • XML and JSON
  • Trading partner ops

Delivery

  • Cross-functional leadership
  • Agile and UAT
  • Release planning
  • Stakeholder alignment

Tools I live in: Jira · Aha! · Confluence · Rally · Pendo · Splunk · GitHub.

EDI analyst, 2004–2018 — Kaiser Permanente, Data Dimensions, WellCare Health Plans, and Universal HealthCare, with additional work at RipIt Sporting Goods, the Pennsylvania Liquor Control Board, and CorpTen International. Project Management, UCF Continuing Education, 2009.

Selected work

Products that moved claims, cash, and the people waiting on both.

01

Availity

Product Manager

August 2022 – Present

Claims, cost, and enrollment for the nation’s health information network — products submitters actually live in, not status pages they refresh.

90%
of organizations on the platform now use Claims Management worklists for rejection and denial handling.
75%
drop in “where is my claim” call-center volume after 2M+ claims were corrected and resubmitted in-product.
27
health plans on the Patient Cost Estimator API, built on real-time eligibility (270/271), with Amazon and Quest Diagnostics as submitters.
$25
EPlus monthly subscription for rejected-claim correction and analytics. Owned pricing and packaging; 1,500 subscribing organizations in under 3 months.

Took the Claims and Encounters Portal from MVP through full release, migrating 320 payers off legacy systems.

02

Optum / UnitedHealthcare

Product Manager

July 2018 – August 2022

Owned the Intelligent EDI clearinghouse suite — iEDI, RCG, and OTI — the pipes every transaction on the platform had to survive.

500M
X12 transactions across all types, leading a team of 11 product owners.
$25M
in additional upsell after launching RCG, which parsed raw X12 into JSON so downstream teams could analyze claim data for clinical editing.
98.9%
clean claim rate on OTI, the HIPAA and payer-specific editing engine every transaction passed through.
1,500
trading partners live on Optum’s API Marketplace — 35 APIs behind self-service onboarding.

Migrated EDI submitters off legacy platforms onto iEDI, running discovery with provider groups and sequencing cutovers so live claim traffic never blinked.

03

InRoll Plus / US Retirement Partners

EDI Product Manager

March 2015 – June 2018

Turned benefits elections from paper and chase-downs into structured self-service — then into the carrier files those elections actually have to become.

700
clients migrated onto a new enrollment portal that generated carrier EDI directly from employee elections.
63%
faster carrier implementations — 120 days down to 45 — by redesigning onboarding, mapping, and testing across 60+ benefits carriers.
1,220
clients and 15 TPAs, including Aetna and CVS/Caremark, whose requirements became the standard for the rest of the partner network.

Led a team of 7 EDI analysts. Authored trading partner guides and test cases, and partnered with data teams on SQL discrepancy reports that caught failures before carriers did.

Family

The most important product I ship every day is not on a roadmap.

Two little humans, a black lab, and as many s’mores as the fire will allow. Off the clock I am a dad first — pretzels, campfires, backyard dinosaurs, and whatever world they invent that week.

I am a product leader. I am also the person who packs the marshmallows.

Contact

Open to conversations about product leadership in healthcare.

If you are building claims, enrollment, or payer integrations — or you just want to talk shop — write me. I read every note.

aarnold@hiremrarnold.com
Email Andrew919-500-1959LinkedInResume