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Product Manager — Prior Authorization
Hello! Thanks in advance for the gift of your time. This role requires some very specific knowledge including:
- familiarity with prior authorization, case management, and pharmacy workflows
- solid understanding of HIPAA, EHR integrations, and clinical data standards (FHIR, HL7 v2, CDA)
- familiarity with microservice architectures, APIs, and cloud services
There will be a deliverable as part of this process and we don't want you to fail! Please review this job description and apply as appropriate.
100% remote and must be performed in the States.
Cover letters are welcomed, appreciated, and reviewed (by a human).
Sadly, we cannot sponsor VISAs.
Company Overview
PrescriberPoint, a Series A startup incubated by BCG Digital Ventures and funded by Lilly, Pfizer, MasterCard, and Adobe, is modernizing how U.S. healthcare professionals (HCPs) get patients on therapy. Our platform streamlines prescribing by bringing together trusted drug information, coverage and prior authorization requirements, patient affordability options, and practice tools—while enabling compliant collaboration with pharmaceutical brand teams. OneHub is our flagship AI-powered workflow automation platform, transforming healthcare case management from manual processes to intelligent, automated conversations.
Role Overview
You will drive execution and outcomes for OneHub—our AI-powered prior authorization and case management platform serving healthcare practices, within the product strategy set by the Director of HCP Product.. Your north star: transform manual, time-consuming PA workflows into intelligent, automated experiences that achieve 30-40% touchless automation while maintaining >80% AI accuracy and earning the trust of clinical staff.
You'll work from a Jobs-To-Be-Done mindset to deeply understand clinical workflows (eligibility checking, PA form completion, medical necessity letters, case tracking), and translate those jobs into intuitive experiences powered by agentic AI capabilities. Critical to success: navigate EMR integration strategies (Epic, Cerner, Athenahealth) and position the platform for TEFCA (Trusted Exchange Framework and Common Agreement) adoption as the national health information exchange framework matures. You'll partner closely with engineering leadership, UX research and design teams, and AI/data science teams to deliver production-ready AI capabilities that reduce administrative burden while ensuring clinical safety and compliance.
What You'll Achieve (Outcomes)
- AI productionization: Ship production-ready ePA question answering and medical necessity letter generation, moving early-stage prototypes to >80% accuracy with comprehensive error handling and clinical validation frameworks.
- Touchless automation: Enable 30-40% touchless ePA processing through intelligent case routing, confidence scoring, and automated form completion—leveraging FHIR-based data exchange and positioning for TEFCA network participation with clear human escalation for complex cases.
- Practice adoption: Drive >5 daily active users in pilot practice, achieving measurable time savings and high satisfaction scores (NPS >70) among clinical staff.
- Agentic experiences: Deliver AI-powered interfaces enabling natural language interactions, intelligent case prioritization, and automated workflow triggers across multiple modalities (voice, text, embedded UI).
- Platform reliability: Maintain system performance with <2 second AI response times, 99.9% uptime, and comprehensive audit trails for all AI decisions and recommendations.
Responsibilities
- Execute flawlessly against product vision: Follow the vision for OneHub to organize and deliver work that delivers against key clinical workflows.
- JTBD research & clinical validation: Lead research to map practice workflows, clinical staff jobs, and trust requirements; partner with healthcare SMEs to validate AI safety and accuracy.
- AI partnership: Work closely with data science and ML/AI teams to productionize AI capabilities—defining confidence thresholds, fallback mechanisms, and clinical decision support requirements.
- Integration strategy: Own integrations with CenterX (ePA), TruePill (pharmacy), EMR systems (Epic App Orchard, Cerner App Gallery, Athenahealth Marketplace), and navigate critical FHIR implementation including evaluation of TEFCA Qualified Health Information Networks (QHINs) for standardized health data exchange.
- Pilot-driven development: Partner with pilot practices for feedback-driven iteration; measure time-to-value, feature adoption, and efficiency gains to validate product-market fit.
- Team collaboration: Work daily with engineering leadership and team in 2-week sprint cycles, writing clear requirements and guiding execution toward measurable outcomes.
- GTM collaboration: Work closely with GTM to ensure product priorities reflect market needs and business strategy.
- Compliance & security: Ensure HIPAA compliance, proper access controls, and comprehensive audit logging for all AI-assisted clinical decisions.
- Metrics & experimentation: Define success metrics (automation rate, AI accuracy, NPS, time savings), instrument analytics, and establish A/B testing framework for continuous improvement.
Competencies
- Healthcare domain depth (required): Deep familiarity with prior authorization workflows, pharmacy processes, hub services, clinical case management, practice operations, and EMR integration patterns.
- AI product experience: Track record working with AI/ML products, particularly conversational AI, automation platforms, or clinical decision support systems.
- Technical depth: Comfortable with .NET microservices architecture, API integrations, Azure infrastructure, and ability to evaluate AI model performance and reliability.
- Customer-centric & JTBD: Demonstrated ability to convert clinical workflows and trust requirements into intuitive product experiences that earn healthcare provider confidence.
- Pilot & validation focus: Experience running structured pilots with clear success criteria, measuring outcomes, and iterating based on real-world feedback.
- Cross-functional influence: Excellent partner to engineering, UX, AI/data teams, and clinical stakeholders; able to navigate technical complexity while maintaining user-centric focus.
Requirements
- Bachelor's degree in a relevant field (Business, Healthcare, CS, or similar) or equivalent experience.
- 3-5+ years in product management with significant time in healthcare technology, SaaS, or B2B platforms serving professional users.
- Proven track record shipping products in agile environments with cross-functional teams, ideally in regulated industries (healthcare, finance).
- Healthcare domain knowledge is requisite, particularly around prior authorization, pharmacy workflows, clinical case management, and practice operations.
- Experience with AI/ML products or automation platforms; understanding of confidence scoring, error handling, and human-in-the-loop workflows is essential.
- Comfortable with technical concepts including APIs, microservices, cloud infrastructure, and ability to collaborate effectively with engineering teams.
- Familiarity with healthcare compliance (HIPAA), electronic health records, and clinical data standards (FHIR, HL7 v2, CDA) is required; understanding of TEFCA framework and QHIN ecosystem is a strong plus.
- Experience with EMR integration strategies (Epic SMART on FHIR, Cerner HealtheIntent, Athenahealth API) and understanding of app marketplace certification requirements.
- Strong analytical skills with experience defining metrics, using product analytics tools, and making data-driven decisions.
- Excellent communication and stakeholder management—able to translate complex technical concepts for clinical users and business stakeholders.
- Bias for action with ability to move quickly in ambiguous environments while maintaining quality and safety standards.
Compensation
The salary range for this role is $100,000 to $125,000 based on location and experience. There is a bonus.
Benefits:
We offer strong benefits for a company at our stage, including a 401k (w/matching), and, while 100% remote, promote in-person human interactions when appropriate.
Beliefs:
PrescriberPoint is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, status as a qualified individual with a disability, veteran status, or other legally protected characteristics. Learn more about your EEO rights as an applicant.
Additionally, we participate in the E-Verify program as required by applicable law. Learn more about E-Verify here.
Last, PrescriberPoint is a drug-free workplace committed to maintaining a safe workplace free from unlawful drugs and alcohol and complies with all applicable laws, including the Federal Drug-Free Workplace Act. Team members are prohibited from reporting to work or performing their duties with any unlawful drugs or alcohol in their system. They are also prohibited from using, possessing, manufacturing, selling, trading, distributing, dispensing or making arrangements or offering to distribute unlawful drugs or alcohol while at work or performing work duties. Any violation of the Company’s drug-free workplace policy may result in disciplinary action, up to and including disqualification from employment or termination, unless otherwise allowed by law.
Benefits of working at PrescriberPoint
- A unique opportunity to materially help the lives of literally millions of health care professionals and patients with a team of like-minded (and amazing!) individuals, led by tested management
- We are unabashedly 100% remote. Not that we don't get together at times but we'd rather trust our Scribes will get their work done, while affording them the flexibility to incorporate their lives into their workday and reducing significant emissions. (It's all life!) Looking both forward and back, this can be priceless.
- Strong health, vision, dental, and accident insurance for a company of our scale
- 401(k) with up to 4% matching (unusual for firms at our stage)
- Yearly educational stipends to grow you
- Open Paid Time Off we proactively track
- BYOD (Bring Your Own Device): We happily include funds with each paycheck to cover any hardware costs you might incur to perform your work. If you have a set up that works, you can pocket the funds. We'll never know.
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