Capability Manager- PBM Pricing - Remote

Primary Responsibilities

• Consuming Application Management: Own the intake, governance, and lifecycle management of PBM Pricing Capability APIs (>70 integrations), serving as the primary liaison between consumer teams and downstream service teams. Support onboarding of new consumers and ongoing optimization of existing integrations
• Support PBM Experience Consistency: Drive consistency in the PBM member and prescriber experience by partnering across capability, product, and technology teams to ensure APIs and downstream integrations deliver aligned, accurate, and predictable outcomes across all consumer touchpoints
• Compliance & Risk Management: Ensure strict compliance with regulatory, privacy, and security standards, including adherence to pricing transparency and representation requirements
• Stakeholder Engagement: Initiate and lead collaborative discussions with a broad range of stakeholders including Product, Underwriting, Sales, Marketing, Technology, Operations, and Reporting. Serve as a trusted, consultative partner to align on requirements and guide effective use of the capability
• Productize / Monetize: Establish and advance an API product strategy that enables monetization, scalability, and enterprise reuse-transforming integrations into standardized, value-generating capabilities
• Innovation & Optimization: Identify opportunities to enhance capability performance, scalability, and consumer experience through automation, AI/ML, and advanced analytics
• Change Management: Lead change management for API modernization initiatives by planning, coordinating, and executing the transition from legacy integrations to modern architectures
• Process Design & Scalability: Define, implement, and continuously improve repeatable/reusable processes to support a growing number of integrations and stakeholders efficiently and at scale

Required Qualifications

• 5+ years in product/capability development or product/capability management, preferably in healthcare or PBM
• 5+ years working in a matrixed organization and across cross-functional teams
• Demonstrated familiarity with APIs, data integration, and system interoperability
• Proven solid communication, stakeholder engagement, and executive presence
• Demonstrated ability to operate in a consultative capacity across diverse stakeholder groups
• Proven solid analytical skills with experience in developing business cases, financial modeling, and data-driven decision-making
• Experience with process improvement, operational design, and building scalable workflows

Preferred Qualifications

• Project management experience or certification (formal or demonstrated through experience managing complex, multi-stakeholder initiatives)
• Experience in the healthcare industry
• Experience in the Pharmacy and/or PBM industry
• Demonstrated ability to leverage data, analytics, and emerging technologies to operate and scale capabilities (e.g., automation, AI/ML, or advanced reporting)
• Experience working in Agile methodology

Pay

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

Benefits

Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.