Sr. Product Manager | Pharmacy Payment Integrity

The company is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

Product Manager, Pharmacy Payment Integrity

The company is seeking a Product Manager to transform pharmacy payment integrity from manual workflows to AI-first automation. Own the product roadmap for AI agents, voice AI and IVR automation, intelligent data acquisition, automated payment/recovery workflows, and customer-facing analytics.

What you'll do

• Agentic workflow automation : Design and ship AI agents that automate COB investigations, primacy determination, validation, claims tagging, and recovery handoff across Medicare, Medicaid, and commercial flows.

• Voice AI and conversational data acquisition : Replace legacy IVR/phone-based verification with AI-powered conversational workflows; integrate third-party insurance discovery APIs and PBM portal automation.

• Payment and recovery automation : Build end-to-end automation for bulk billing, auto-invoicing, denial recovery, and recovery submission workflows.

• Customer-facing analytics : Redesign the customer portal with real-time dashboards, SLA transparency, recovery pipeline visibility, and self-service reporting that crystallizes customer ROI

• AI agent capabilities : Define agent behavior, decision logic, human-in-the-loop handoffs, quality guardrails, and pilot-to-scale deployment plans.

• Operational transformation : Partner with operations teams to identify high-volume, low-complexity workflows for automation; translate domain expertise into automated logic.

Requirements

• Computer Science degree (BS/MS required)

• 5+ years of combined prior experience as both Product Manager AND Software Engineer (hands-on coding background required)

• Technical understanding of agentic AI architectures, voice interfaces, API integrations, data pipelines, and BI platforms

• Track record transforming manual processes into automation-first products with measurable ROI

• Experience building customer-facing analytics for external clients

• Strong collaboration with operations and domain experts

• Management consulting experience and healthcare domain knowledge are a strong plus

What We Offer

• Work from anywhere in the US! The company is digital-first.

• Top Medical/Dental/Vision offerings

• FSA/HSA

• Tuition reimbursement

• Competitive salary, 401(k) with company match

• Unlimited PTO

• Additional health and wellness benefits and perks

• Flexible and trusting environment where you’ll feel empowered to do your best work

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.

Equal Employment Opportunity at the company

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. The company is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at:  [link for members]