Sr. Product Manager | Pharmacy Payment Integrity

Machinify is a leading healthcare intelligence company focused on delivering value and efficiency to health plan clients. They are seeking a Product Manager to lead the transformation of pharmacy payment integrity through AI-first automation, overseeing the product roadmap and various automation workflows.

Responsibilities:

• Design and ship AI agents that automate COB investigations, primacy determination, validation, claims tagging, and recovery handoff across Medicare, Medicaid, and commercial flows
• Replace legacy IVR/phone-based verification with AI-powered conversational workflows; integrate third-party insurance discovery APIs and PBM portal automation
• Build end-to-end automation for bulk billing, auto-invoicing, denial recovery, and recovery submission workflows
• Redesign the customer portal with real-time dashboards, SLA transparency, recovery pipeline visibility, and self-service reporting that crystallizes customer ROI
• Define agent behavior, decision logic, human-in-the-loop handoffs, quality guardrails, and pilot-to-scale deployment plans
• Partner with operations teams to identify high-volume, low-complexity workflows for automation; translate domain expertise into automated logic

Requirements:

• Computer Science degree (BS/MS required)
• 5+ years of combined prior experience as both Product Manager AND Software Engineer (hands-on coding background required)
• Technical understanding of agentic AI architectures, voice interfaces, API integrations, data pipelines, and BI platforms
• Track record transforming manual processes into automation-first products with measurable ROI
• Experience building customer-facing analytics for external clients
• Strong collaboration with operations and domain experts
• Management consulting experience and healthcare domain knowledge are a strong plus