Senior Product Manager, Rightway
PBM Platform
$150-195k
+ bonus and equity
Personalized healthcare platform for employees
Open for applications
Personalized healthcare platform for employees
501-1000 employees
Open for applications
$150-195k
+ bonus and equity
501-1000 employees
Company mission
To simplify the healtcare experience.
Role
Who you are
- It requires someone who can take full ownership of a major product initiative and work cross-functionally across product, engineering, operations, clinical, and compliance
- Bachelor's degree required; 5 or more years of product management experience, preferably in healthcare or enterprise technology
- Experience with complex, rules-driven transaction processing systems such as claims adjudication, payments, or benefit administration, including responsibility for correctness and testing
- Experience leading a platform migration or major system transition from requirements through go-live
- Proven ability to lead cross-functional initiatives involving product, engineering, legal, and operations stakeholders
- Ability to work independently and drive execution with minimal direction
- Strong communicator who collaborates well across technical and non-technical teams
- Detail oriented and process focused, and comfortable in a domain where correctness is measured claim by claim
- Comfortable working across complex, data-heavy systems
- Curious and adaptable, willing to dig into unfamiliar and highly technical territory and find answers
- Experience working in or with PBMs, pharmacy claims, or pharmacy operations is a plus
- Familiarity with systems that support regulated healthcare markets, including Medicare, is a plus
- Knowledge of pharmacy-related data standards such as NCPDP or Medi-Span is a plus
- Exposure to APIs, system integrations, or healthcare data platforms is a plus
- An advanced degree in a relevant field (MBA, MPH, or a technical degree) is a plus
What the job involves
- Rightway is looking for a Senior Product Manager to own claims adjudication, the system at the center of Rightway’s PBM
- Adjudication covers the full lifecycle of a pharmacy claim: eligibility, coverage, pricing, rejections, overrides, and coordination of benefits
- It is one of the most complex and consequential product areas at Rightway, and this role owns its strategy, roadmap, and delivery
- You will develop deep expertise in how pharmacy claims adjudicate today and use that to define where the platform goes next — working through real claim behavior alongside engineering, writing requirements precise enough to build against, setting the bar for correctness, and owning the validation approach that proves the system is ready for production volume
- The role reports to the Director, Product Management, and operates with a high degree of independence
- Own the vision, roadmap, and delivery plan for claims adjudication, including how it scales with volume, new clients, and new lines of business
- Build deep expertise in how pharmacy claims adjudicate across eligibility, coverage rules, pricing, rejections, overrides, and coordination of benefits, and turn that into a structured, prioritized plan
- Define the long-term strategy for how the platform evolves to support operational scale, regulatory requirements, and new lines of business, including Medicare
- Write clear specs, user stories, and acceptance criteria that engineering and QA can execute against, and lead backlog refinement, sprint planning, and release coordination in an agile environment
- Partner day to day with the adjudication engineering team to sequence work, manage dependencies, and resolve ambiguity in claim behavior quickly
- Set the bar for correctness and own the testing and claim certification approach that proves the system is ready for production volume
- Own readiness and rollout planning, including validation against real claim volume, parallel testing, and phased release
- Coordinate go-live readiness across operations, clinical, client success, and compliance so changes land without disruption to members or clients
- Partner with PBM operations, clinical, legal, and client success teams to ensure the platform meets workflow and regulatory requirements
- Manage the drug data, formulary, and prior authorization dependencies adjudication relies on, treating the internal teams who own them as first-class partners
- Define and track KPIs for claim accuracy, system performance, and reliability
- Act as the primary product point of contact for adjudication across the organization and with external partners
Our take
Modern healthcare ecosystems are fragmented, so patients have to organize multiple services to get the care they need. This can be complex, time-consuming and expensive, which is why Rightway provides a unified healthcare organizational system to manage employee healthcare benefits better.
The company’s aim is to simplify access to healthcare, whilst also saving users money through price comparison services. Examples of its offerings are a pharmacy services platform that enables employees to access medication via a smartphone app, and the Advocate platform that helps to close care gaps.
The startup serves companies of all sizes, from small businesses to enterprises like Burger King, Popeyes and RBI. It has hundreds of thousands of users across the US, and has raised considerable funding which will enable it to further develop its platform and strengthen its foothold among employers, health plans, third-party administrators and other potential clients.
Kirsty
Company Specialist at Welcome to the Jungle
Company
Funding (last 2 of 6 rounds)
Mar 2024
$108.8m
LATE VC
Mar 2021
$100m
SERIES C
Total funding: $240.8m
Company benefits
- Competitive compensation
- Health Savings Account
- External learning and career development panels
- Hybrid in-office culture and commuter benefits at our NYC HQ
- Full medical, dental, and vision insurance
- 401K
Company HQ
West Village, New York, NY
Leadership
Jordan Feldman
(Co-Founder & CEO)Studied Government and Economics at Harvard before working in investment at Goldman Sachs and Redbird.
Theodore Feldman
(Co-Founder & Chief Medical Officer)Also Chief Medical Officer at Cadence. They studied Medicine at Harvard University and the Albert Einstein College of Medicine. Worked as Medical Director at South Miami Heart Centre and the Head of Cariology at FIU Wertheim College.
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