Senior Product Manager – Medicare, EGWP

Job not on LinkedIn

November 26

Apply Now

Receive Emails with Similar Jobs

SmithRx

WebsiteLinkedInAll Job Openings

Healthcare Insurance • SaaS • B2B

SmithRx is a transparent, pass-through pharmacy benefits manager (PBM) that operates independently from insurance companies and pharmacies to align its incentives with self-insured employers and their members. By leveraging modern technology, SmithRx aims to reduce the cost and complexity of pharmacy benefits, ensuring the delivery of effective and low-cost drugs. The company is dedicated to transforming the pharmacy benefits landscape through its flat-rate, transparent pricing model and innovative cost savings programs, which connect members to the lowest cost drugs without the use of spread pricing, rebates, or other tactics. SmithRx's commitment to transparency and superior customer service results in significant savings for employers and a highly satisfactory experience for its members.

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

☁️ SaaS

🤝 B2B

💰 $20M Series B on 2022-03

📋 Description

• Define and drive the multi-year product roadmap for the company's Medicare Part D and EGWP offerings, identifying key 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 (e.g., Coverage Gap and Catastrophic phases), compliance requirements, and recent changes (e.g., IRA impacts like the $2,000 Out-of-Pocket Cap). • Lead the full product lifecycle from ideation and market research through development, launch, performance tracking, and continuous optimization, leveraging an 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 robust business cases, including financial modeling and KPI definition, to justify product investments and optimize product positioning, pricing, and profitability. • Present product strategies, compliance updates, and performance results to internal leadership, client-facing teams, and potentially external clients, influencing decision-making and driving adoption.

🎯 Requirements

• 5+ years of progressive experience in Product Management or related domain, with a minimum of 3 years dedicated to Medicare Part D, EGWP, or Managed Care products within the PBM, Health Plan, or Healthcare Technology space. • Expert-level knowledge of Medicare Part D benefit structure, the regulatory environment (including CMS guidance), and the operational nuances of Employer Group Waiver Plans (EGWP). • Proven ability to lead cross-functional collaboration across engineering, operations, and design to deliver high-impact solutions. • Strong analytical skills with experience leveraging AI tools for efficiency • Ability to prioritize and deliver in a fast-paced, cross-functional environment. • Excellent communication skills, with the ability to translate technical concepts into business impact for diverse audiences. • Bachelor’s degree in Business, Healthcare Administration, or a related field. Advanced degree (MBA, MHA) or relevant certifications are a plus.

🏖️ Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance • Flexible Spending Benefits • 401(k) Retirement Savings Program • Short-term and long-term disability • Discretionary Paid Time Off • 12 Paid Holidays • Wellness Benefits • Commuter Benefits • Paid Parental Leave benefits • Employee Assistance Program (EAP) • Well-stocked kitchen in office locations • Professional development and training opportunities