Product Manager, COB, Pharma CoPay Programs, Client Organization Model Administration

Position Summary:

The Product Manager owns the strategy, roadmap, and delivery of core healthcare benefit solutions, including Coordination of Benefits (COB), Pharma Copay programs, Client Organization Model Administration (Hierarchy), the Member Portal experience, and high-level Benefit Administration Portal navigation. This role is responsible for defining and executing a product vision that delivers measurable value to payers, PBMs, pharmacies, manufacturers, and ultimately patients—balancing regulatory requirements, operational efficiency, platform usability, and user experience.

In addition to core benefit functionality, this role oversees the administration of complex client hierarchies that mirror real-world organizational structures, ensuring scalable and flexible configuration across enterprise customers. The Product Manager also drives the evolution of the Member Portal, delivering intuitive, self-service capabilities that improve engagement, transparency, and satisfaction. At the platform level, they shape the enterprise navigation framework within RxIQ to ensure consistent, logical, and efficient user flows across modules supporting role-based workflows without extending into identity and access management ownership.

By deeply understanding customer workflows, industry standards, and compliance considerations, the Product Manager identifies opportunities to streamline benefit processing, improve financial accuracy, reduce friction across stakeholders, and enhance program performance. They translate business and market needs into clearly defined product requirements, prioritized backlogs, and outcome-based success metrics. Through close partnership with engineering, architecture, operations, and commercial teams, they ensure scalable, reliable, and compliant solutions are delivered with clarity around scope, acceptance criteria, and quality expectations.

The role also drives continuous improvement through data-driven experimentation and iteration—leveraging launch results, performance metrics, and customer feedback to optimize capabilities, expand impact, and inform strategic investment decisions. As the product manager for these critical benefit platforms and enterprise experience layers, this leader ensures alignment across cross-functional teams while maintaining a strong focus on long-term platform scalability, customer value, and business growth.

To Be Successful in This Role, the Ideal Candidate Will

• Develop deep expertise across Coordination of Benefits (COB), Pharma Copay programs, Client Organization Model Administration (Hierarchy), Member Portal experiences, and Benefit Administration Portal navigation.
• Understand how enterprise client hierarchies mirror real-world organizational structures and how those structures drive benefit configuration, eligibility, reporting, and operational workflows.
• Distill complex healthcare benefit, compliance, and platform concepts into clear, actionable insights for both technical and non-technical stakeholders.
• Balance regulatory requirements, operational efficiency, financial accuracy, and user experience when defining product direction.
• Think holistically about the enterprise platform experience—ensuring cohesive navigation and intuitive workflows across modules.

Expectations

• Serve as the subject matter expert for COB, Pharma Copay programs, Client Organization Model Administration (Hierarchy), Member Portal capabilities, and Benefit Administration Portal navigation within RxIQ.
• Lead strategy and execution for system enhancements, new client implementations, RFP support, and configuration models across these domains.
• Ensure client organizational structures are scalable, flexible, and accurately represented within the platform to support complex enterprise needs.
• Drive evolution of the Member Portal to enhance self-service capabilities, transparency, and engagement for end users.
• Shape and optimize high-level enterprise navigation patterns to ensure consistent, logical, and efficient user flows across the RxIQ platform (excluding direct IAM ownership).
• Remain current with regulatory and industry requirements (COB, Medicare, Medicaid, and related benefit regulations) to ensure ongoing compliance.
• Partner with engineering, architecture, operations, and commercial teams to define quarterly roadmaps aligned to long-term platform vision.
• Collaborate across adjudication and other core enterprise product areas to maintain a comprehensive understanding of the full RxSense platform ecosystem.
• Own and manage the product backlog, prioritizing development based on measurable business impact, customer value, scalability, and risk mitigation.
• Develop detailed feature specifications with clear acceptance criteria and outcome-based success metrics.
• Leverage data, performance metrics, launch outcomes, and customer feedback to drive continuous improvement and strategic investment decisions.
• Demonstrate strong systems thinking and intellectual curiosity to understand how benefit logic, hierarchy models, and enterprise workflows function at a foundational level.
• Define and execute a forward-looking strategy across benefit platforms and enterprise experience layers that aligns with RxSense business goals and customer needs.
  
  
  

Desired Skills & Experience

• 4+ years of experience at a PBM or healthcare organization, with direct exposure to Coordination of Benefits (COB), Medicaid, and/or Medicare programs.
• 4+ years working within agile product teams, business functions, or related environments.
• Experience with benefit administration platforms, organizational hierarchy models, or enterprise SaaS configuration tools strongly preferred.
• Familiarity with member-facing web or mobile portal experiences and UX considerations.
• Understanding of enterprise SaaS navigation frameworks and cross-module user experience design.
• Experience using JIRA (or similar tools) for roadmap planning, backlog management, sprint visualization, and prioritization.
• Proven ability to self-manage, make data-driven decisions, and operate both autonomously and collaboratively in cross-functional environments.
• Strong written and verbal communication skills, with demonstrated ability to align engineering, operations, compliance, and commercial stakeholders.
• Strategic mindset with the ability to connect platform scalability, customer value, compliance requirements, and business growth objectives.

Salary Range: 100,000 - 149,000