{"id":2505683,"url":"https://alion.io/job/rightway-senior-product-manager-pbm-platform","title":"Senior Product Manager, PBM Platform","company":{"id":174582,"name":"Rightway","domain":"rightwayhealthcare.com","url":"https://alion.io/company/rightway-2","size_band":"501-1000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Greenhouse","truth_index":null},"role":"Product","role_family":"Product","seniority":"senior","employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["New York, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":150000,"max":195000,"currency":"USD","period":"year","gross":null,"usd_annual":195000},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-09-15T20:24:20Z","employer_posted_date":"2026-09-15","last_verified_at":"2026-10-29T12:09:33Z","board_verified":true,"closed_at":null,"days_open":43,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":43},"description":"ABOUT THE ROLE:\n\nRightway 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.\nYou 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. It requires someone who can take full ownership of a major product initiative and work cross-functionally across product, engineering, operations, clinical, and compliance.\nWHAT YOU’LL DO:\nOwn the vision, roadmap, and delivery plan for claims adjudication, including how it scales with volume, new clients, and new lines of business\nBuild 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\nDefine the long-term strategy for how the platform evolves to support operational scale, regulatory requirements, and new lines of business, including Medicare\nWrite 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\nPartner day to day with the adjudication engineering team to sequence work, manage dependencies, and resolve ambiguity in claim behavior quickly\nSet the bar for correctness and own the testing and claim certification approach that proves the system is ready for production volume\nOwn readiness and rollout planning, including validation against real claim volume, parallel testing, and phased release\nCoordinate go-live readiness across operations, clinical, client success, and compliance so changes land without disruption to members or clients\nPartner with PBM operations, clinical, legal, and client success teams to ensure the platform meets workflow and regulatory requirements\nManage the drug data, formulary, and prior authorization dependencies adjudication relies on, treating the internal teams who own them as first-class partners\nDefine and track KPIs for claim accuracy, system performance, and reliability\nAct as the primary product point of contact for adjudication across the organization and with external partners\nWHO YOU ARE:\n\nBachelor's degree required; 5 or more years of product management experience, preferably in healthcare or enterprise technology\nExperience with complex, rules-driven transaction processing systems such as claims adjudication, payments, or benefit administration, including responsibility for correctness and testing\nExperience leading a platform migration or major system transition from requirements through go-live\nProven ability to lead cross-functional initiatives involving product, engineering, legal, and operations stakeholders\nAbility to work independently and drive execution with minimal direction\nStrong communicator who collaborates well across technical and non-technical teams\nDetail oriented and process focused, and comfortable in a domain where correctness is measured claim by claim\nComfortable working across complex, data-heavy systems\nCurious and adaptable, willing to dig into unfamiliar and highly technical territory and find answers\nExperience working in or with PBMs, pharmacy claims, or pharmacy operations is a plus\nFamiliarity with systems that support regulated healthcare markets, including Medicare, is a plus\nKnowledge of pharmacy-related data standards such as NCPDP or Medi-Span is a plus\nExposure to APIs, system integrations, or healthcare data platforms is a plus\nAn advanced degree in a relevant field (MBA, MPH, or a technical degree) is a plus\nCOMPENSATION: $150,000 - $195,000 annually, in addition to bonus and equity\nCompensation offered will be determined by geographic location, experience, and qualifications.\nCYBERSECURITY AWARENESS NOTICE\nIn response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. \nABOUT RIGHTWAY:\nRightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.\nSince its founding in 2017, Rightway has raised over $300mm from investors including Khosla Ventures, Thrive Capital, Francisco Partners, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.\nHOW WE LIVE OUR VALUES TO OUR TEAMMATES:\nWe’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our core values:\n1) We are human, first\n Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to-and hear-each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.\n2) We redefine what is possible\n We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.\n3) We debate then commit\n We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.\n4)We cultivate grit\n Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.\n5) We seek to delight \n Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.\nRightway is proud to be an Equal Opportunity Employer that believes in the strength of diverse thought, beliefs, backgrounds, and education. We foster an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis protected by applicable law. 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