About The Position

The Principal roles leads strategic product development and innovation for the Coverage Review Organization (CRO), driving execution of coverage review solutions across pharmacy and medical benefit management. This role blends product management and implementation strategy to deliver seamless experiences for health plan partners and members, ensuring compliance, operational excellence, and client satisfaction. The position influences enterprise transformation, staying ahead of market trends, regulatory changes, and technology to maintain competitive, innovative strategies. It requires close collaboration with Pharmacy Benefit Services (PBS) product and clinical teams to co-create solutions, integrate clinical insights, and ensure excellence throughout the product lifecycle.

Requirements

  • Bachelor’s degree in Pharmacy, Pharm.D. preferred, with current active U.S. Pharmacist License
  • Minimum of 10+ years in product management, client implementation and operations leadership within pharmacy benefit management.
  • Experience in Regulated Markets/CMS/Medicare/Medicaid
  • Proven track record of delivering complex product solutions and driving operational readiness at scale.
  • Strong knowledge of pharmacy and medical drug authorization processes, compliance standards, and payer/provider dynamics.
  • Exceptional leadership, communication, and stakeholder management skills.
  • If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Responsibilities

  • Define and execute product vision, strategy, and roadmap aligned with enterprise objectives and regulatory requirements.
  • Lead and support the end-to-end product lifecycle activities, including ideation, design, enhancements, and performance monitoring.
  • Utilize market insights, client feedback, and operational data to inform product innovation and continuous improvement.
  • Establish success metrics and KPIs for product performance and refine based on outcomes.
  • Oversee implementation of new products and enhancements across CRO, ensuring readiness of systems, workflows, and teams.
  • Develop structured implementation plans integrating compliance standards and client-specific requirements.
  • Partner with cross-functional teams (Operations, IT, Compliance, Clinical) to ensure timely and accurate delivery of solutions.
  • Serve as the primary escalation point for client readiness issues, driving resolution and maintaining strong relationships.
  • Influence long-term product roadmap decisions impacting pharmacy and medical drug authorization processes.
  • Represent CRO in enterprise forums, advocating for operational needs and client priorities.
  • Stay abreast of industry trends, emerging technologies, and best practices.
  • Conduct competitive analysis to ensure products are differentiated and deliver maximum value.

Benefits

  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

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What This Job Offers

Job Type

Full-time

Career Level

Principal

Number of Employees

5,001-10,000 employees

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