Program Manager – Prior Authorization Solutions

RXinsider LTD.; Northern (KY); Hybrid; USD 100,000 - 150,000; Full time

Job summary

Agadia Health Systems, Inc. is seeking a highly skilled Program Manager to lead strategic initiatives for our cloud-based prior authorization platform and drive process improvements across the organization.

You will manage cross-functional projects, align product, engineering, client success, and business operations, and contribute to a high-visibility SaaS environment. This role requires healthcare domain expertise, strong communication, and the ability to develop roadmaps, timelines, and

Qualifications

• 3–7 years of experience in program management, product operations, or implementation within healthcare technology.
• Proven ability to manage complex, multi-stakeholder programs in a fast-paced SaaS environment.
• Excellent communication, analytical, and organizational skills.
• Ability to manage multiple priorities in a fast-paced environment with minimal supervision.
• Highly self-motivated, professional, take-charge attitude with humility and integrity.
• Direct experience with prior authorizations at a health plan, PBM, or UM organization.
• Experience with PAHub (preferred) or another enterprise PA platform.
• Familiarity with SDLC.
• Background in pharmacy benefit management, medical benefit management, or healthcare operations.
• PMP, Agile, or Lean certification.

Responsibilities

• Own the end-to-end delivery of cross-functional programs that enhance our prior authorization SaaS platform.
• Facilitate and manage cross-functional operational projects across various areas of the organization.
• Support contract management, including tracking contract status, coordinating reviews, and ensuring timely renewals and compliance.
• Assist with resource planning, including capacity tracking, forecasting, and cross-team coordination.
• Develop program roadmaps, timelines, and success metrics aligned with organizational goals.
• Drive execution across product, engineering, operations, and client-facing teams.
• Identify and implement process improvements that enhance operational efficiency and scalability.

Job description

Reports To: Vice President, Customer Experience

Location: Remote/Hybrid with 10% travel to Parsippany, NJ

Position Summary

We are seeking a highly skilled Program Manager to lead strategic initiatives for our cloud-based prior authorization platform as well as lead process improvement programs to benefit the entire organization. You will manage cross-functional projects, streamline operational processes, and ensure alignment between product, engineering, client success, and business operations. This is a high ‑ visibility role that blends program execution, operational rigor, and healthcare domain expertise. This role is ideal for someone who understands the complexities of healthcare and operations as well as the nature of working in a SaaS company.

Key Responsibilities

Program Leadership, Operational Support & Business Process Management

• Own the end-to-end delivery of cross-functional programs that enhance our prior authorization SaaS platform.
• Facilitate and managecross-functionaloperational projects acrossvarious areas of the organization.
• Support contract management, including tracking contract status, coordinating reviews, and ensuringtimelyrenewals and compliance.
• Assistwith resource planning, including capacity tracking, forecasting, and cross-team coordination.
• Develop program roadmaps, timelines, and success metrics aligned with organizational goals.
• Drive execution acrossproduct, engineering, operations, and client-facing teams.
• Identifyand implement process improvements that enhance operational efficiency and scalability.

Required Qualifications

• 3–7 years of experience in program management, product operations, or implementation within healthcare technology,including at an enterpriseSaas company
• Proven ability to manage complex, multi-stakeholder programs in a fast-paced SaaS environment
• Excellent communication, analytical, and organizational skills
• Ability to manage multiple prioritiesin a face-paced environment with minimal supervision
• Highly self-motivated, professional, take-charge attitude with humility and integrity

Preferred Qualifications

• Direct experience with prior authorizations at a health plan, PBM, or UM organization
• Experience with PAHub (preferred) or another enterprise PA platform
• Familiarity withSDLC
• Background in pharmacy benefit management, medical benefit management, or healthcare operations
• PMP, Agile, or Lean certification

Success Measures

• Smooth delivery of high-impact programsand projectswithin our organization
• Clear, measurable improvements in product adoption, workflow efficiency, and client satisfactionStrong relationships with internal teams built on trust andexpertise
• Thought leadership in shaping the future ofa growing SaaS company

Agadia Health Systems, Inc. is a leading healthcare management technology company addressing the evolving needs of the managed care market with a suite of utilization management solutions in electronic prior authorization, MTM, Part D star ratings & adherence, grievances, and formulary benefit design. Used by the nation’s largest health plans and PBMs, Agadia’s advanced technology solutions help drive operational efficiency, appropriate utilization , compliance, and profitability

Agadia is an Equal Opportunity Employer

This position offers a unique opportunity to influence customer success, product adoption, and the overall customer experience strategy while serving as a recognized PAHub expert across the organization.

Pay Range: Actual compensation will be determined based on the candidate's experience, qualifications, and work location. Candidates in different geographic markets may be offered compensation that reflects local market conditions.