Innovaccer is looking to solve the business and technical problem of streamlining prior authorization (PA) solutions within Pharmacy Benefits Management (PBM), with a particular focus on real-time benefit transparency and specialty (oncology) workflows to accelerate patient access to therapy and reduce delays in treatment initiation.
Requirements
- Strong understanding of prior authorization workflows, NCPDP SCRIPT, RTPB/RTPD standards, and FHIR interoperability.
- 8+ years of product management experience in healthcare technology, with at least 4+ years in PBM, pharmacy benefit solutions, or specialty drug management.
- Experience working with PBMs, specialty pharmacies, and oncology benefit management.
- Proven ability to design and scale digital products in payer–provider ecosystems.
Responsibilities
- Own the product vision and roadmap for PA solutions in the PBM and specialty (oncology) domain.
- Drive integration of RTPB (Real-Time Prescription Benefit) protocols and RTPD (Real-Time Prescription Data) protocols into provider and pharmacy workflows to enable cost transparency, benefit checks, and early PA triggers.
- Work with engineering to design FHIR-based APIs, NCPDP-compliant workflows, and ePA integrations that support PBM benefit structures.
- Build solutions that flag PA requirements upfront and surface covered alternatives (e.g., generics, biosimilars) to prescribers.
- Define success metrics, monitor adoption, and optimize product performance for payer and provider customers.
- Represent the product in client discussions, industry forums, and PBM partnerships.
Other
- Proven experience bringing provider, payer, and PBM stakeholders together to streamline prior auth and accelerate patient access to therapy.
- Partner with PBMs, payers, specialty pharmacies, and oncology care teams to reduce delays in treatment initiation.
- Collaborate cross-functionally with clinical, data, and compliance teams to ensure oncology-specific PA workflows meet regulatory and operational needs.
- Translate market, regulatory, and customer insights into actionable product features and requirements.
- Excellent stakeholder management skills, with ability to influence PBMs, payers, providers, and internal leadership.
- Strong analytical and problem-solving skills with a track record of delivering measurable outcomes.
- Bachelor’s degree required; advanced degree (MBA, MPH, or PharmD) preferred.
