Senior Product Manager, PBM Platform

The role

The Senior Product Manager will own the strategy, roadmap, and delivery for the claims adjudication system. This role involves managing the full lifecycle of pharmacy claims and working cross-functionally to ensure system correctness and scalability.

What you will do

• Own the vision, roadmap, and delivery plan for claims adjudication
• Build expertise in pharmacy claims adjudication across eligibility, coverage, pricing, rejections, overrides, and coordination of benefits
• Define long-term strategy for platform evolution to support scale and regulatory requirements
• Write clear specs, user stories, and acceptance criteria
• Lead backlog refinement, sprint planning, and release coordination
• Partner with the adjudication engineering team to manage dependencies and resolve ambiguity
• Set the bar for correctness and own the testing and claim certification approach
• Own readiness and rollout planning including parallel testing and phased release
• Coordinate go-live readiness across operations, clinical, client success, and compliance
• Manage drug data, formulary, and prior authorization dependencies

Required qualifications

• Bachelor's degree
• 5 or more years of product management experience
• Experience with complex, rules-driven transaction processing systems such as claims adjudication, payments, or benefit administration
• Experience leading a platform migration or major system transition from requirements through go-live
• Ability to work independently and drive execution with minimal direction

Nice to have

• Experience working in or with PBMs, pharmacy claims, or pharmacy operations
• Familiarity with systems that support regulated healthcare markets, including Medicare
• Knowledge of pharmacy-related data standards such as NCPDP or Medi-Span
• Exposure to APIs, system integrations, or healthcare data platforms
• An advanced degree in a relevant field (MBA, MPH, or a technical degree)

About the company

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Their products guide patients to the best care and medications through a modern, mobile app.