Product Manager Healthcare Technology & Pharmacy Benefit Management (PBM)

This is a W2 Role, C2C will not work


Product Manager Job Description

Position Title: Product Manager Healthcare Technology & Pharmacy Benefit Management (PBM)

Location: Remote

Please share me your resume and please call me asap

Client Accenture for CVS Caremark

Overview

We are seeking a dynamic Product Manager with a proven track record in healthcare technology, pharmacy benefit management (PBM), and Medicare/Medicaid systems. The ideal candidate will have extensive experience driving end-to-end product delivery, leading cross-functional teams, and implementing innovative solutions that optimize workflows, improve user experience, and ensure regulatory compliance. This role is responsible for managing the full product lifecycle-from ideation through launch and ongoing optimization-across digital health, PBM, and insurance platforms.

Key Responsibilities

• Lead the development and delivery of healthcare and PBM products, with a focus on Medicare and Medicaid claims processing, eligibility, formulary management, pricing, and reimbursement1.
• Champion the design and implementation of scalable API architectures (FHIR, REST, GraphQL) for healthcare insurance products, enabling high-performance, reliable, and secure data workflows1.
• Oversee the launch of digital platforms and analytics tools, including member benefits portals and predictive claims analytics, to enhance user access, reduce costs, and improve claims accuracy1.
• Collaborate with cross-functional Agile teams (developers, business analysts, stakeholders) to define requirements, prioritize backlogs, and deliver features aligned with business goals and evolving regulatory requirements1.
• Track and report on key product KPIs, ROI, and performance metrics, using insights to inform strategic decisions and continuous improvement initiatives1.
• Manage risk, scope, and budget for product initiatives, ensuring timely delivery and alignment with organizational objectives1.
• Maintain up-to-date knowledge of Medicare and Medicaid policy changes, proactively ensuring all products and enhancements remain compliant1.
• Facilitate user feedback sessions, training, and documentation to drive adoption and optimize operational workflows1.
• Advise senior leadership on PBM innovation and digital transformation, serving as a subject-matter expert in balancing cost controls, compliance, and member satisfaction1.

Required Qualifications

• Bachelor's degree in Information Technology, Computer Science, Healthcare Administration, or related field1.
• Strong knowledge of Medicare and Medicaid claims processing, eligibility verification, formulary management, and reimbursement workflows1.
• Hands-on experience with Agile methodologies (Scrum, SAFe), backlog management (JIRA, Rally, DevOps), and cross-functional team leadership1.
• Excellent communication, stakeholder management, and documentation skills1.
• Certifications: Certified Scrum Master (CSM), PMP, and/or SAFe preferred1.