Required RxCLAIM Product Owner - REMOTE

Qualifications 

 10+ years of experience in RxCLAIM or any other Pharmacy Benefit Management (PBM) systems Product Ownership

• Own and drive the product vision, roadmap, and backlog for RxCLAIM-based solutions
•  Align product strategy with PBM business goals, regulatory requirements, and client needs
• Define and prioritize features, enhancements, and technical initiatives based on business value RxCLAIM & PBM Domain Accountability
• Act as subject matter expert (SME) for RxCLAIM modules including:- Claims adjudication 
• Plan setup & benefit configuration - Pricing, accumulators, and edits - Prior authorization & DUR - Eligibility, formularies, and networks
• Leverage experience with other PBM systems (e.g., MedImpact, Argus, custom PBM platforms) to drive best practices and comparative insights
• Support integrations with downstream and upstream systems (eligibility, providers, pharmacies, rebate systems, data warehouses) Agile Delivery & Stakeholder Management - Serve as Product Owner in Agile/Scrum teams, owning user stories, acceptance criteria, and backlog grooming
• Work closely with architects, developers, QA, and DevOps teams to ensure high-quality delivery
• Collaborate with business stakeholders, clients, operations, and compliance teams - Participate in PI planning, sprint planning, demos, and retrospectives Compliance & Quality
• Ensure solutions comply with CMS, HIPAA, Medicaid/Medicare, and state-specific regulations
• Partner with compliance and audit teams during regulatory changes and implementations - Drive data accuracy, performance, and scalability across PBM solutions Continuous Improvement - Analyze production issues, client feedback, and operational metrics to identify improvement opportunities - Support modernization initiatives such as cloud migration, automation, and API enablement - Mentor junior product owners and business analysts in PBM and RxCLAIM best practices