Lead Product Manager (Medicaid)
HumanaSalary not specified
Full Time
Senior (5 to 8 years), Expert & Leadership (9+ years)
Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Health-Tech, Pharmacy Benefit ManagementIndustries
Requirements
- Deep understanding of CMS regulations, particularly Medicare Part D and EGWP rules (e.g., annual bid processes, benefit design like Coverage Gap and Catastrophic phases, compliance requirements, IRA impacts like $2,000 Out-of-Pocket Cap)
- Expertise in the dynamics of the retiree health market
- Ability to translate complex regulatory and market requirements into scalable, tech-driven product solutions
- Experience serving as a primary subject matter expert guiding cross-functional teams and senior leadership
Responsibilities
- Define and drive the multi-year product roadmap for Medicare Part D and EGWP offerings, identifying opportunities for differentiation, cost management, and member experience improvement
- Serve as the internal Subject Matter Expert (SME) on CMS Part D and EGWP rules, including annual bid processes, benefit design, compliance requirements, and recent changes (e.g., IRA impacts)
- Lead the full product lifecycle from ideation and market research through development, launch, performance tracking, and continuous optimization, leveraging Agile methodology
- Collaborate with stakeholders across Engineering, Design, Operations, Clinical, Finance, Legal, and Compliance teams to define detailed product requirements (user stories), manage the product backlog, and ensure seamless delivery and operational readiness
- Conduct competitive analysis and build market and financial analysis
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the company culture like at SmithRx?
SmithRx has a mission-driven and collaborative culture that inspires employees to do their best work, guided by core values of Integrity, Courage, and Together.
What are the main responsibilities of the Senior Product Manager role?
You will own the vision, strategy, and execution of the Medicare Part D and EGWP product line, define and drive the multi-year product roadmap, and serve as the primary subject matter expert on CMS regulations and the retiree health market.
What skills and expertise are required for this position?
The role requires a deep understanding of CMS regulations, the dynamics of the retiree health market, and the ability to translate complex regulatory and market requirements into scalable, tech-driven product solutions.
Is this a remote position or does it require office work?
This information is not specified in the job description.
What is the salary or compensation for this role?
This information is not specified in the job description.
SmithRx
Pharmacy benefit management with transparent pricing
About SmithRx
SmithRx operates as a Pharmacy Benefit Manager (PBM) that focuses on managing prescription drug plans for self-insured employers and plan sponsors. The company uses a transparent pricing model called "Pass Through Pricing," where it charges only an administrative fee and passes all rebates from prescriptions directly to clients and their members. This model contrasts with traditional PBMs that often inflate drug prices and retain rebates for profit. SmithRx's clients benefit from a technology platform that utilizes real-time data to improve service delivery, ensuring efficient and high-quality pharmacy benefit management. The company also provides a concierge service to enhance support for both members and clients. SmithRx aims to simplify pharmacy benefits while maximizing value for its clients through transparency, advanced technology, and exceptional customer service.
San Francisco, CaliforniaHeadquarters
2016Year Founded
$94.8MTotal Funding
SERIES_CCompany Stage
HealthcareIndustries
201-500Employees
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Disability Insurance
Health Savings Account/Flexible Spending Account
Unlimited Paid Time Off
Paid Holidays
Wellness Program
Commuter Benefits
Parental Leave
Mental Health Support
Professional Development Budget
Risks
Increased competition from technology-driven PBMs like Capital Rx could erode market share.
Rapid technological advancements may require costly updates to SmithRx's platform.
Potential regulatory scrutiny on PBM pricing models could impact SmithRx's business model.
Differentiation
SmithRx uses a transparent 'Pass Through Pricing' model, unlike traditional PBMs.
The company leverages real-time data for efficient pharmacy benefit management services.
SmithRx offers concierge-level service, enhancing customer satisfaction and support.
Upsides
SmithRx secured $60M in Series C funding, indicating strong investor confidence.
Partnership with Banjo Health enhances prior authorization processes using AI technology.
Collaboration with TheracosBio offers cost-effective drug options for Type 2 Diabetes.
Related Jobs
RemoteRemoteProgram Manager, Medicare Part D Implementation
Devoted HealthSalary not specified
RemoteProduct Video Producer, Creative Lead
CalendlySalary not specified
- Full Time
- Senior (5 to 8 years)
RemoteSenior Product Manager, Investment Products
EmpowerSalary not specified
- Full Time
- Senior (5 to 8 years)
RemoteDirector of Product Management, Consumer Products
TalkiatrySalary not specified
- Full Time
- Senior (5 to 8 years), Expert & Leadership (9+ years)
RemoteProduct Owner
BrightseedSalary not specified
- Full Time
- Mid-level (3 to 4 years), Senior (5 to 8 years)