Develop Health
Clinical Product & Operations Lead Pharmacist
Remote. Posted a month ago
The role
You will support customers with moderate-to-complex prior authorization and benefit verification cases. You will also design operational processes and work with product and engineering teams to improve AI-driven workflows.
What you will do
- Own customer support for moderate-to-complex prior authorization and benefit verification cases
- Apply clinical judgment to navigate payer criteria, formulary requirements, and appeals
- Build support foundations by documenting workflows, playbooks, and SOPs
- Surface patterns to product and engineering to help prioritize fixes
- Work with engineering to improve AI agents through feedback on casework
- Manage customer communication across email, calls, and Slack
- Own the operational playbook for complex cases
- Build and track metrics like resolution time and approval rates
- Design and scale training for new pharmacists and technicians
- Partner with engineering to decide what to automate next
Required qualifications
- Licensed pharmacist (PharmD)
- Hands-on prior authorization and benefit verification experience
- 3–5+ years in pharmacy operations, specialty pharmacy, or a payer/PBM environment
- Strong working knowledge of PA workflows, payer criteria, formularies, and PBM structures
- Excellent written and verbal communication
- Real customer-facing experience explaining clinical concepts simply
- Comfort working cross-functionally with product, engineering, and operations
- Availability to work on-site in Menlo Park at least three days per week
Nice to have
- Experience building QA processes or supervising pharmacists and technicians
- Deep understanding of the patient access journey, from prescription to dispensing
- Comfort using AI tools to work faster day to day
Benefits
- Health, dental, and vision coverage
- Flexible PTO
- High-end workstation & tooling budget
About the company
Develop Health uses AI to accelerate access to life-saving medications by automating healthcare processes. The team includes founders and engineers who have previously launched and exited healthcare startups.