Role overview
Own the product direction for automating pharmacy payment integrity workflows with AI, conversational systems, and connected data services. The work spans operational tools and customer-facing reporting, with a focus on turning manual investigations and recovery processes into reliable automation that can demonstrate value to health plan customers.
Responsibilities
- Set the roadmap for AI-driven workflows covering coordination-of-benefits investigations, coverage primacy decisions, validation, claims tagging, and recovery handoffs.
- Design conversational voice workflows to replace phone and IVR verification, integrating insurance discovery services and pharmacy benefit manager portals.
- Develop automation for billing, invoicing, denial follow-up, and payment recovery submissions.
- Improve customer analytics and portal experiences with timely dashboards, service-level visibility, recovery tracking, and self-service reports.
- Define agent decision logic, human review handoffs, quality safeguards, and plans for moving pilots into broader deployment.
- Work with operations specialists to identify automatable processes and translate their expertise into product rules and measurable outcomes.
Requirements
- Bachelor's or master's degree in computer science.
- At least five years of combined experience working as both a product manager and a software engineer, including hands-on coding.
- Technical understanding of agent-based AI, voice interfaces, APIs, data pipelines, and business intelligence platforms.
- Demonstrated success converting manual processes into automation-focused products with measurable return on investment.
- Experience building analytics products for external customers.
- Strong ability to collaborate with operations teams and domain specialists.
Nice to have
- Healthcare industry experience or a background in management consulting.
Benefits and work setup
- Remote work from anywhere in the United States in a digital-first environment.
- Medical, dental, and vision coverage; flexible spending and health savings accounts; tuition reimbursement; and a retirement plan with employer matching.
- The source also lists flexible paid time off, equity, and additional health and wellness offerings. Compensation depends on candidate experience, skills, and other factors.