Senior PBM Product Manager

About the position

The Senior Product Manager- Clinical Programs is accountable for the leadership and execution of the development, launch, and ongoing management of clinical programs. This individual will drive strategic initiatives, create innovative solutions, and be responsible for achieving measurable improvements in member health outcomes, quality of care, and cost savings for both members and clients. The role demands a results-driven leader with a strategic mindset to ensure customer growth, deliver savings, and create a differentiated experience across the product lifecycle. Medicare experience highly desired.

Responsibilities

• Own the strategic development, implementation, and management of clinical programs, ensuring they align with business goals and produce measurable results in both the short and long term.
• Lead and influence senior stakeholders, including the Director of Product Management, to shape the product and service roadmap, driving initiatives forward with clear accountability.
• Serve as a decision-maker and authority on product strategy, competitive positioning, client needs, and emerging trends in PBM and healthcare markets.
• Identify and seize opportunities for product enhancements by leveraging industry expertise, proactively addressing client needs, and ensuring compliance with Medicare requirements.
• Oversee cross-functional collaboration to drive timely execution of comprehensive project plans, ensuring seamless product rollouts and successful post-launch support.
• Direct market research initiatives to maintain a competitive edge, identify market opportunities, and define product identity, with a focus on Medicare-specific requirements.
• Provide strategic leadership on product positioning, packaging, and pricing to ensure competitiveness, profitability, and compliance with Medicare regulations.
• Lead the development of market-facing collateral in partnership with marketing, ensuring the product portfolio is well-positioned and effectively communicated across all stages of its lifecycle.
• Advise and guide clinical strategy initiatives to enhance operational efficiency, maximize product adoption, and ensure market competitiveness.
• Drive internal and external stakeholders through the complexities of clinical program implementation, ensuring a high level of accountability, especially regarding Medicare product offerings.
• Promptly report any allegations of impropriety to the Compliance Department.
• Comply with Maxor’s Ethical Business Conduct policy and Medicare/Medicaid program requirements.
• Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists.

Requirements

• Proven accountability for leading product launches, managing the product lifecycle from development through to strategic pricing and market success.
• Extensive expertise in PBM claims adjudication, benefit setup, pharmacy operations, and vendor management, ensuring operational excellence and product success.
• Strong financial acumen, with the ability to conduct financial analysis and make data-driven decisions to optimize product performance.
• Ability to build and enforce alignment and accountability across cross-functional teams, with the proven ability to lead stakeholders at all organizational levels.
• Proficiency in relevant tools (Microsoft PowerPoint, Word, Excel, Visio, Outlook, Salesforce, Smartsheet, Confluence, and Jira) to ensure effective management and delivery of initiatives.
• Demonstrated client-facing experience, with a track record of leading discussions in finalist presentations and driving strategic outcomes in client meetings.
• Experience in contract review and negotiation, with proven success in securing favorable terms that drive business growth and client satisfaction.
• Ability to thrive in a fast-paced environment, prioritizing multiple projects and maintaining accountability within a matrix organization.

Nice-to-haves

• Strong leadership and accountability skills, with the ability to mentor junior team members and drive results without direct authority.
• Exceptional project management and organizational skills, with the capacity to manage multiple projects and deadlines efficiently.
• Proven expertise in product billing, compensation modeling, and strategic pricing, with a focus on healthcare and clinical programs, particularly in Medicare.
• Expert knowledge of market research, competitive analysis, and product positioning, ensuring products are well-positioned in the market to meet business goals.
• Comprehensive experience in vendor evaluation, selection, and management, ensuring seamless execution of product launches and ongoing product performance.
• Strong client relationship management skills, with a focus on delivering value and maintaining compliance with industry regulations, especially within Medicare.

Benefits

• Comprehensive mental health and wellbeing resources
• Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
• Company-paid basic life/AD&D, short-term and long-term disability insurance
• Rx, dental, vision, other voluntary benefits, and FSA
• Employer-matched 401k Plan
• Industry-leading PTO plan
• And more!