USAClinical Product & Operations Lead Pharmacist
1 мес. назад
170k–220k USD / yearUSALeadOnsite
clinical workflowsprior authorizationbenefit verification
Clinical Product & Operations Lead Pharmacist to manage customer experience and operational workflows involving benefit verification and prior authorization in healthcare.
Обязанности
- We’re hiring a Clinical Product & Operations Lead Pharmacist to be the clinical anchor of our customer experience. You’ll be the person customers reach when a prior authorization or benefit verification case gets hard, and the person our product and engineering teams turn to when they need to know how the work actually happens.
- This is an individual contributor role for a licensed pharmacist who can own moderate-to-complex cases end to end and build the workflows around them. Your time splits across two connected jobs: supporting customers directly on tough cases, and designing the operational processes, internal and customer-facing, that hold quality high as we scale.
- We’re looking for someone as comfortable on a customer call as they are writing an SOP or sitting with an engineer to explain why a payer criterion matters. Expect startup pace, real ambiguity, and a lot of ownership. This role is based in our Menlo Park office at least three days per week.
- Own customer support for moderate-to-complex prior authorization and benefit verification cases, serving as the primary point of contact for escalations and providing clear clinical context, status, and a path to resolution.
- Apply clinical judgment to navigate payer criteria, formulary requirements, and appeals on the cases staff can’t resolve on their own.
- Build the support foundations: document workflows, write playbooks and SOPs, and turn one-off fixes into repeatable processes.
- Be the voice of the customer with product and engineering. Surface patterns in where customers get stuck, flag errors in AI-generated determinations, and help prioritize what gets fixed.
- Work directly with engineering to make our AI agents better at real casework: feeding hard PA and BV cases back into the product, flagging where determinations go wrong, and shaping the agentic workflows that handle them.
- Manage customer communication across email, calls, and Slack with clarity and care, especially in high-stakes patient situations.
Требования
- How ’s platform and automation fit into real payer/PBM processes, and where the product creates leverage in customer operations.
- Our internal escalation paths and engineering workflows, and how to raise an issue so it gets resolved fast.
- How different payers interpret PA and BV requirements, and how those differences show up in customer experience.
- How our AI generates clinical responses and determinations, so you can review them and give engineers feedback they can act on.
Будет плюсом
- Experience building QA processes or supervising pharmacists and technicians.
- Deep understanding of the patient access journey, from prescription to dispensing, including common failure modes and payer friction.
- Comfort using AI tools to work faster day to day.
Условия
- $170,000–$220,000 base salary plus meaningful early-stage equity.
- Health, dental, and vision coverage; flexible PTO.
- High-end workstation & tooling budget.
- The chance to make medication access dramatically faster for hundreds of thousands of patients every month.
Другое
- is on a mission to use AI to radically accelerate access to life-saving medications. By automating complex, manual healthcare processes—like benefit verification and prior authorization— we’ve achieved 10x revenue growth over the past year, growing from $0 to >$10M in annual recurring revenue in less than 2 years, and currently help more than 400,000 new patients every month .
- We’re partnering with some of the largest pharmacy benefit managers and payers in the nation, revolutionizing how healthcare interactions occur by eliminating human delays and inefficiencies. Our small, elite team of founders and engineers have previously launched and exited successful healthcare startups including Rupa Health and Canvas Medical. We are now scaling rapidly following a major funding round.
- Own the operational playbook for how complex PA and BV cases get handled, internally and for customers, and keep it current as payer rules change.
- Build and track the metrics that show impact: resolution time, approval rates, and where automation helps versus where it still breaks.
- Become a defining voice in how the product evolves by translating what you see in support into high-leverage improvements.
- Design and scale training so new pharmacists and technicians ramp fast and hold the same quality bar.
- Help shape how the pharmacy operations and support function works as we expand across payers, PBMs, and enterprise partners.
- Partner with engineering to push more complex casework onto AI agents: deciding what to automate next, where a human still needs to be in the loop, and how to keep quality high as the agents take on more.
- Licensed pharmacist (PharmD) with hands-on prior authorization and benefit verification experience.
- 3–5+ years in pharmacy operations, specialty pharmacy, or a payer/PBM environment.
- Strong working knowledge of PA workflows, payer criteria, formularies, and PBM structures, enough to handle moderate-to-complex cases on your own.
- Excellent written and verbal communication, including real customer-facing experience explaining clinical concepts simply.
- Comfort working cross-functionally with product, engineering, and operations in a fast-paced startup.
- Availability to work on-site in Menlo Park at least three days per week.