SmithRx is a tech-forward PBM committed to changing the way pharmacy benefits are managed.
Senior Product Manager – Adjudication
Location
United States
Posted
5 days ago
Salary
Not specified
Job Description
Job Requirements
- 5+ years of progressive experience in Product Management or a related technical domain, with a minimum of 3+ years dedicated to claims adjudication, pharmacy switch technology, or PBM core platforms.
- Deep technical knowledge of NCPDP Telecommunication Standards (specifically Version D.0) and the transactional workflows between pharmacies, switches, and PBMs.
- Expertise in complex benefit strings, including real-time pricing logic, Coordination of Benefits (COB), and eligibility verification.
- Proven ability to lead cross-functional collaboration across Engineering, Data Science, and Operations to deliver high-concurrency, low-latency technical solutions.
- Strong analytical skills with experience leveraging AI tools and data modeling to improve system efficiency, audit claim accuracy, and automate exception handling.
- High-stakes delivery: Ability to prioritize and execute in a fast-paced environment where system uptime and financial accuracy are mission-critical.
- Excellent communication skills, with the unique ability to translate claim logic into clear business impact for executive leadership and clients.
- Significant plus: experience incorporating EGWP guidelines into adjudication logic; a strong understanding of CMS-mandated benefit phases and their technical implementation
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
- Paid Company Holidays
- Wellness Benefits
- Commuter Benefits
- Paid Parental Leave benefits
- Employee Assistance Program (EAP)
- Well-stocked kitchen in office locations
- Professional development and training opportunities
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