Machinify

Healthcare

Sr.ProductManager|PharmacyPaymentIntegrity

United States Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Senior candidates.

The Brief

“Sr. Product Manager | Pharmacy Payment Integrity at Machinify. Skills: Product Management, AI Automation, Pharmacy Payment Integrity. Own product roadmap for AI agents. Own product roadmap for voice AI and IVR automation”

What You'll Achieve.

Transform pharmacy payment integrity from manual workflows to AI-first automation; Maximize financial outcomes; Drive down healthcare costs; Deliver unmatched value, transparency, and efficiency

Industry & Context.

Healthcare

What They're Looking For.

Must Have

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

Nice to Have

Management consulting experience, healthcare domain knowledge

What You'll Do.

Own product roadmap for AI agents

Own product roadmap for voice AI and IVR automation

Own product roadmap for intelligent data acquisition

Own product roadmap for automated payment/recovery workflows

Own product roadmap for customer-facing analytics

Design and ship AI agents

Automate COB investigations

Automate primacy determination

Automate claims tagging

Automate recovery handoff

Replace legacy IVR/phone-based verification

Integrate third-party insurance discovery APIs

Build end-to-end automation for bulk billing

Build end-to-end automation for auto-invoicing

Build end-to-end automation for denial recovery

Build end-to-end automation for recovery submission

Redesign customer portal

Define AI agent behavior

Define AI agent decision logic

Define human-in-the-loop handoffs

Define AI agent quality guardrails

Define AI agent pilot-to-scale deployment plans

Partner with operations teams

low-complexity workflows

Translate domain expertise into automated logic

How You'll Work.

Team & Collaboration

Collaboration with operations teams; Collaboration with domain experts

Full Job Description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs. Product Manager, Pharmacy Payment Integrity Machinify is seeking a Product Manager to transform pharmacy payment integrity from manual workflows to AI-first automation. Own the product roadmap for AI agents, voice AI and IVR automation, intelligent data acquisition, automated payment/recovery workflows, and customer-facing analytics. What you'll do Agentic workflow automation: Design and ship AI agents that automate COB investigations, primacy determination, validation, claims tagging, and recovery handoff across Medicare, Medicaid, and commercial flows. Voice AI and conversational data acquisition: Replace legacy IVR/phone-based verification with AI-powered conversational workflows; integrate third-party insurance discovery APIs and PBM portal automation. Payment and recovery automation: Build end-to-end automation for bulk billing, auto-invoicing, denial recovery, and recovery submission workflows. Customer-facing analytics: Redesign the customer portal with real-time dashboards, SLA transparency, recovery pipeline visibility, and self-service reporting that crystallizes customer ROI AI agent capabilities: Define agent behavior, decision logic, human-in-the-loop handoffs, quality guardrails, and pilot-to-scale deployment plans. Operational transformation: Partner with operations teams to identify high-volume, low-complexity workflows for automation; translate domain

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