Key skills
CloudAgileScrumLeadershipStakeholder Management
About this role
Role Overview
- Lead the product vision, roadmap, and delivery for enterprise PBM solutions
- Collaborate with business, clinical, and technology stakeholders to deliver scalable, compliant, and high-performing pharmacy solutions
- Translate complex PBM requirements into actionable product backlogs while driving continuous value delivery
- Serve as Product Owner in Agile/Scrum teams, owning user stories, acceptance criteria, and backlog grooming
- Work closely with architects, developers, QA, and DevOps teams to ensure high-quality delivery
- Collaborate with business stakeholders, clients, operations, and compliance teams
Requirements
- 10+ years of experience in RxCLAIM or any other Pharmacy Benefit Management (PBM) systems
- Product Ownership
- Own and drive the product vision, roadmap, and backlog for RxCLAIM-based solutions
- Align product strategy with PBM business goals, regulatory requirements, and client needs
- Define and prioritize features, enhancements, and technical initiatives based on business value
- RxCLAIM & PBM Domain Accountability
- Act as subject matter expert (SME) for RxCLAIM modules including: Claims adjudication, Plan setup & benefit configuration, Pricing, accumulators, and edits
- Prior authorization & DUR, Eligibility, formularies, and networks
- Leverage experience with other PBM systems (e.g., MedImpact, Argus, custom PBM platforms) to drive best practices and comparative insights
- Support integrations with downstream and upstream systems (eligibility, providers, pharmacies, rebate systems, data warehouses)
- Agile Delivery & Stakeholder Management
- Serve as Product Owner in Agile/Scrum teams, owning user stories, acceptance criteria, and backlog grooming
- Work closely with architects, developers, QA, and DevOps teams to ensure high-quality delivery
- Collaborate with business stakeholders, clients, operations, and compliance teams
- Participate in PI planning, sprint planning, demos, and retrospectives
- Compliance & Quality
- Ensure solutions comply with CMS, HIPAA, Medicaid/Medicare, and state-specific regulations
- Partner with compliance and audit teams during regulatory changes and implementations
- Drive data accuracy, performance, and scalability across PBM solutions
- Continuous Improvement
- Analyze production issues, client feedback, and operational metrics to identify improvement opportunities
- Support modernization initiatives such as cloud migration, automation, and API enablement
- Mentor junior product owners and business analysts in PBM and RxCLAIM best practices.
Tech Stack
- Cloud
Benefits
- Competitive salary package, share plan, company performance bonuses, value-based recognition awards, referral bonus
- Career coaching, global career opportunities, non-linear career paths, internal development programmes for management and technical leadership
- Complex projects, rotations, internal tech communities, training, certifications, coaching, online learning platforms subscriptions, pass-it-on sessions, workshops, conferences
- Hybrid work and flexible working hours, employee assistance programme
- Global internal wellbeing programme, access to wellbeing apps
- Global internal tech communities, hobby clubs and interest groups, inclusion and diversity programmes, events and celebrations.