Platform Director, Pharmacy Claims & Adjudication

Prescryptive Health, Inc.; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

Prescryptive Health, Inc. is seeking a Director of Product for the Pharmacy Claims Platform.

You will own the roadmap for adjudication and transaction capabilities, partnering with engineering and operations to deliver scalable, production-ready solutions that impact members, pharmacies, and clients. The role requires 8+ years in product management with hands-on leadership of pharmacy claims systems, strong PBM knowledge, and the ability to translate complex rules into clear requirements and

Qualifications

• 8+ years in product management or related platform roles with ≥3 years owning pharmacy claims adjudication product requirements and delivery.
• Deep knowledge of pharmacy claims adjudication, PBM operations, and transaction lifecycle including eligibility, pricing, and cost share.
• Hands-on understanding of NCPDP transactions, including rejects, reversals, resubmissions, coordination of benefits, and scale.
• Ability to translate complex business rules into product requirements, acceptance criteria, and testing scenarios with API fluency.
• Proven cross-functional leadership across engineering, business, and operations with clear decision making.

Responsibilities

• Own the product direction and lead the roadmap for core adjudication and transaction capabilities across Prescryptive's platform.
• Advance adjudication capabilities across the claims lifecycle including eligibility, benefit configuration, pricing, and financial reconciliation.
• Partner with engineering to shape platform capabilities, interfaces, and integrations for reliable, scalable solutions.
• Lead through complexity by aligning technical and business needs, resolving competing priorities, and driving accountability.
• Drive delivery and readiness across teams to move requirements into production with thorough validation.
• Measure impact using transaction data and operational metrics to improve outcomes and ensure privacy, security, and compliance.

Skills

Direct adjudication ownership

PBM & pharmacy claims expertise

NCPDP transaction knowledge

APIs & data models

Cross-functional leadership

Analytical communication

Tools

APIs

Data models

Job description

Prescryptive Health, Inc. is seeking a Director of Product for the Pharmacy Claims Platform.

You will own the roadmap for adjudication and transaction capabilities, partnering with engineering and operations to deliver scalable, production-ready solutions that impact members, pharmacies, and clients. The role requires 8+ years in product management with hands-on leadership of pharmacy claims systems, strong PBM knowledge, and the ability to translate complex rules into clear requirements and