Kumar Binit Rai

Professional Experience Summary

Manager, Technical Prduct Management – CURO Platform, Optum

• Lead the CURO Utilization Management portfolio supporting 2.65M delegated members, 19 clients across multiple states, and 50,000+ internal/external staff using CURO capabilities across Care Delivery.
• Drive roadmap strategy and execution across 8 Scrum teams, enabling UM processing for 4.8M Prior Authorizations, 263k admissions, and 3.4M auto‑decisioned cases annually.
• Partner with clinical, engineering, and business leadership to optimize UM workflows, improving auto‑decision rates to 71%, accelerating EDI throughput to 3.95M transactions per year, and achieving 94% electronic delivery for provider communications.
• Champion responsible AI use cases (AI Dojo graduate) such as case summarization and guided workflows, complementing existing automation that saves 1316 provider minutes per encounter and contributes to an 81.8% symptom-triage completion rate.
• Lead client onboarding, UAT, release readiness, and solution delivery for enterprise partners such as WellMed—impacting 360k+ referred cases, 329k ADT-driven actions, and 1.39M completed assessments annually across CURO-CM and Clinical programs.
• Oversee platform capabilities supporting downstream systems, including 1.2M referral volume, 33.7k care pathway transactions, 69k active Optum Pro registrants, and 1221 PRIME enrollments YTD—ensuring alignment with enterprise care management workflows.
• Improve delivery predictability by >25% through strengthened governance (QBRs, release planning, risk/mitigation), while enhancing backlog health by 30% through discovery rigor and TPM coaching.
• Mentor TPMs across strategy, prioritization frameworks, stakeholder influence, and value articulation—elevating product maturity across CURO programs.
• Recognized by senior leadership for exceptional UM domain expertise, delivery leadership, and foundational contributions to CURO’s expansion since its inception.

• Owned and prioritized the Product Backlog for the CURO Medical Management platform, ensuring alignment across multiple scrum teams supporting large‑scale UM operations.
• Partnered with clinical, business, and engineering groups to translate complex UM workflows into clear requirements and support multi‑release product roadmaps.
• Served as the primary liaison for internal and external stakeholders, helping shape high‑impact enhancements used by thousands of CURO end users.
• Communicated backlog priorities, roadmap changes, and development progress with transparency to leadership and operational teams—improving delivery clarity and trust.
• Collaborated closely with Scrum Masters to guide and support delivery teams, contributing to improved sprint stability and predictable release cycles.
• Acted as the SME for assigned CURO modules, advising development and QA and helping reduce requirement-related rework by ~10–15%.
• Promoted Agile best practices, managed defect triage, and improved backlog health by ~20% through disciplined story refinement and prioritization.
• Analyzed product usage, UM volume trends, and operational data (e.g., referral and pathway volumes) to identify enhancement opportunities and support future roadmap decisions.
• Promoted to Lead/Manager, Technical Product Management based on strong delivery performance, expanded cross‑team leadership, and measurable impact on CURO platform quality and execution.

• Facilitated end‑to‑end requirements gathering sessions with business, clinical, operations, and engineering stakeholders, managing the entire product lifecycle from concept through launch and optimization.

• Conducted market research, regulatory analysis, and client discovery sessions to define product vision and ensure alignment with Medicare and Medicaid requirements across Utilization Management and Appeals & Grievances workflows.

• Led the design and delivery of multi‑million‑dollar Appeals & Grievances (A&G) product capabilities serving Medicare Advantage and Medicaid populations, improving compliance, audit readiness, and operational efficiency.

• Managed Business Analysts within the Product Line Group, ensuring clear documentation, traceability, and alignment of functional requirements, technical specifications, and performance expectations.

• Published, owned, and continuously maintained the enterprise Product Roadmap, ensuring visibility to senior leadership, cross-functional partners, and client teams.

• Coordinated and executed Customer UAT for large national clients, validating end-to-end workflows across UM and A&G systems; delivered client training, onboarding, and readiness sessions.

• Oversaw performance monitoring of released features, ensuring reliability, user adoption, and measurable value realization for both internal and external stakeholders.

• Successfully led multi‑million‑dollar enterprise releases across multiple scrum teams, ensuring high-quality delivery, stakeholder alignment, and timely deployment across clinical and operational business units.

• Defined consumer experience and managed solution documentation processes.
• Collaborated with IT teams to ensure solution value and performed UAT scripts.
• Conducted detailed requirement analysis and translated business needs into technical specifications.
• Provided expert consultation on solution design and implementation to meet client requirements.
• Facilitated workshops and training sessions for clients to ensure successful solution adoption.
• Developed and maintained strong relationships with clients, acting as a trusted advisor.
• Utilized data analytics to identify opportunities for solution enhancements and optimizations.
• Ensured compliance with industry standards and regulatory requirements in solution design.
• Managed project timelines and deliverables, ensuring on-time and within-budget delivery.

• Led the definition, prioritization, and delivery of Utilization and Care Management solutions.
• Participated in PI planning and facilitated cross-team coordination.
• Managed schedule and task tracking systems and provided quality assurance.
• Collaborated with cross-functional teams to gather and document requirements effectively.
• Created user-friendly documentation for system functionalities and user training materials.
• Conducted data analysis to support strategic planning and resource allocation initiatives.

• Led full-cycle implementation of EHR and Patient Portal solutions, including requirements gathering, system configuration, workflow alignment, data migration, and readiness assessments.
• Traveled across multiple U.S. cities to support onsite client go‑lives, resolve issues in real time, and ensure smooth operational transitions.
• Delivered customized onsite and virtual training for physicians, nurses, billing staff, front-desk teams, and practice managers to enable confident system adoption.
• Conducted detailed workflow analysis and gap assessments to tailor system modules such as scheduling, charting, e‑prescribing, labs, billing, and reporting to each practice's needs.
• Configured and optimized Patient Portal features to enhance patient engagement, secure messaging, appointment access, and online self‑service capabilities.
• Provided onsite command center support during go‑lives, managing issue triage, coordinating rapid resolutions, and escalating critical items across technical teams.
• Developed implementation artifacts including SOPs, workflow diagrams, training guides, and post‑go‑live optimization plans for long-term client success.
• Ensured HIPAA compliance and maintained secure access controls during system setup and training.
• Supported post‑go‑live stabilization by monitoring user adoption, resolving support tickets, and optimizing workflows based on real-world utilization.
• Built strong client relationships by communicating proactively, providing best‑practice recommendations, and guiding clinics through advanced system capabilities.