Senior PM, Pharmacy Claims Adjudication Platform

Rightway; New York (NY); On-site; USD 150,000 - 195,000; Full time

Job summary

Rightway in New York City is seeking a Senior Product Manager to own claims adjudication—the core system behind our PBM. You will shape the strategy, roadmap, and delivery for eligibility, coverage, pricing, rejections, overrides, and coordination of benefits, driving correctness at scale with production-ready specs.

You will write precise user stories and acceptance criteria, partner with engineering and operations, and lead cross-functional initiatives across product, clinical, legal, and

Qualifications

• Bachelor's degree in a relevant field is required.
• Experience with complex, rules-driven transaction systems preferred.
• Experience leading platform migrations and cross-functional initiatives.

Responsibilities

• Own the vision, roadmap, and delivery plan for claims adjudication across eligibility, coverage, pricing, and COB.
• Write clear specs, user stories, and acceptance criteria for engineering and QA; lead backlog refinement and sprint planning.
• Partner with adjudication engineering, operations, clinical, and compliance to ensure regulatory alignment and successful go-lives.

Skills

Product management

Healthcare domain knowledge

Cross-functional leadership

Requirements writing

Agile / Scrum

Education

Bachelor's degree

Job description

Rightway in New York City is seeking a Senior Product Manager to own claims adjudication—the core system behind our PBM. You will shape the strategy, roadmap, and delivery for eligibility, coverage, pricing, rejections, overrides, and coordination of benefits, driving correctness at scale with production-ready specs.

You will write precise user stories and acceptance criteria, partner with engineering and operations, and lead cross-functional initiatives across product, clinical, legal, and