Director Product Pharmacy Claims Platform

About Prescryptive Prescryptive is the healthcare technology company enabling the direct access marketplace for prescription drugs. Our platform aligns incentives so affordability, choice, and patient access become the natural outcome of a functioning system. Learn more about us by following us on LinkedIn or visiting Prescryptive.com. We're looking for a Director, Product (Pharmacy Claims Platform) who brings deep experience developing pharmacy claims adjudication technology, understands how it works in a real-world PBM environment, and wants to help advance sophisticated pharmacy transaction capabilities. You'll work closely with engineering and business teams to set product direction, solve complex technical and operational challenges, and deliver reliable, scalable technology that supports our pharmacy solutions. You'll need strong product judgment, a deep understanding of the claims lifecycle, and an appreciation for how product decisions affect members, pharmacies, clients, and financial outcomes. We're looking for more than familiarity with claims processing. You'll need direct experience leading the development, enhancement, and delivery of adjudication platform capabilities, along with a strong understanding of the operational and financial implications of how claims are processed. You'll report to our Chief Product Officer and work closely with Product, Engineering, Operations, Clinical, Finance, and other teams. Lead the roadmap and priorities for core pharmacy adjudication and transaction capabilities, balancing business needs, operational requirements, and technical considerations. Define requirements across the pharmacy claims lifecycle, including eligibility, benefit configuration, pricing, clinical edits, member cost share, accumulators, and financial reconciliation. Shape platform capabilities, interfaces, and integrations to deliver reliable, scalable solutions that work across Prescryptive's products. Use processing performance, transaction data, and operational metrics to identify opportunities, guide improvements, and connect product decisions to business and customer outcomes. At least 8 years in product management or related platform roles, including at least 3 years directly accountable for the product requirements, priorities, and production delivery of a pharmacy claims adjudication engine or substantial core adjudication platform capabilities. Deep PBM and pharmacy claims expertise. Strong working knowledge of pharmacy claims adjudication, PBM operations, and the full transaction lifecycle, including eligibility, benefit configuration, pricing, member cost share, accumulators, and downstream financial outcomes. Demonstrated understanding of how adjudication platforms perform in production and the operational implications of product decisions. Knowledge of pharmacy transaction standards and processing. Hands-on understanding of NCPDP transactions, including rejects, reversals, resubmissions, coordination of benefits, and the complexities of claims processing at scale. Demonstrated ability to translate complex business and processing rules into clear product requirements, acceptance criteria, and testing scenarios, with technical fluency in APIs, data models, configurable rules, and high-volume transaction systems. Ability to use transaction data and operational metrics to diagnose problems and improve outcomes, communicate effectively with technical and executive audiences, and incorporate privacy, security, compliance, and auditability requirements into product decisions. Experience with direct responsibility for operating or supporting production pharmacy adjudication platforms, including troubleshooting complex claims processing issues and maintaining operational performance. Experience delivering major adjudication platform enhancements, integrations, and phased releases while maintaining continuity of production operations. Experience across both commercial and government pharmacy benefits, including configurable benefit and pricing rules. Experience with pharmacy payment processes, financial reconciliation, and settlement workflows. Bachelor's degree in business, healthcare, engineering, computer science, or a related field, or equivalent relevant experience. Flexible time off, including 12 paid holidays

• 100% employer-paid medical, dental, and vision premiums
• Company contribution to Health Savings Account
• Stock options

The projected annual salary for this position is $177,500 to $222,500. When preparing an offer, we consider the candidate’s resume, experience, interview feedback, internal equity, and location. Prescryptive does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law.