Senior Product Manager, Clinical Risk
1 day ago
Austin
Location: Remote (EST/CST preferred), NYC area encouraged We’re seeking a strategic yet hands-on Product Manager to create a wholly new set of products at Rightway: the tools that help us forecast, monitor, and mitigate PBM contractual guarantee risk. Rightway’s PBM business model includes contractual guarantees that an employer population will only spend X dollars on medications in a given year. When spend exceeds that level, Rightway may be responsible for paying back a portion of our PMPM fees. This role will build the internal products and data foundations that enable our teams to identify risk earlier, pinpoint the key drivers of overages, and equip clinical teams with actionable insights to intervene, improving member outcomes while reducing avoidable financial leakage. In the first 6 months, you’ll focus on building a monitoring and risk identification system that: • identifies employer customers trending toward overages, • surfaces the members driving spend, • highlights clinically appropriate medication alternatives and intervention opportunities You’ll work closely with our Financial Risk team, partner with clinical outreach teams, and lead a cross-functional squad that includes application engineers, data engineers, and analysts, with design support as needed. • Own the product vision and roadmap for Rightway’s Clinical Risk & Engagement product suite, balancing near-term delivery (monitoring + identification) with a longer-term path to proactive and automated engagement., • Define the end-to-end “risk to action” workflow across teams: forecast → detect risk → explain drivers → prioritize opportunities → enable outreach → measure impact., • Build tools that reduce or replace manual analysis by enabling:, • automated monitoring of employer populations against contractual guarantee thresholds, • trend detection using contract rules and claims-based spend, • clear views into “what changed” and “why we’re trending over”, • Create dashboard-style experiences to identify and understand the members driving spend, enabling rapid drill-down from customer → cohort → member., • Partner with clinical teams to develop a high-signal workflow that supports outreach and behavior change, including:, • a prioritized, ranked “chase list” of members based on estimated intervention value, • member context (condition, medication usage) and clinically appropriate alternatives, • clear explanations that help clinical teams act confidently and consistently, • Ensure outputs are practical for real outreach operations (not just analytics), and iterate with fast feedback loops., • Partner with Data Engineering and Analytics teams to define the models and datasets that power these products, leveraging:, • Rx claims, medical claims, • demographics (age, sex), • member-provided information (health profile submissions), • Set standards for usability and trust: timeliness, data quality, explainability, and auditability (especially where contract rules and dollars are involved)., • Explore opportunities to incorporate AI/ML where it improves model quality and prioritization without sacrificing interpretability and reliability., • Translate business needs into detailed requirements, user stories, acceptance criteria, and success metrics., • Lead discovery with financial risk and clinical partners; align stakeholders around scope, sequencing, and tradeoffs., • Manage a prioritized backlog across application engineering and data teams; ship iteratively and improve based on adoption and outcomes., • 3+ years of product management experience delivering complex, cross-functional products., • Strong comfort working with data-heavy systems (dashboards, internal tools, analytics products, forecasting/monitoring)., • Proven ability to turn ambiguous workflows into shipped software that changes how teams operate., • Experience partnering closely with engineering, data engineering, and analysts to define models, instrumentation, and reliable reporting., • Ability to communicate clearly with technical and non-technical stakeholders and align them around measurable outcomes., • Experience bringing a product from 0 to 1, from the beginning of ideation through launch support., • Experience in healthcare, PBM, claims analytics, or clinical data., • Experience with financial risk products (forecasting, monitoring, guarantees, margin protection, unit economics)., • Exposure to AI/ML concepts (predictive modeling, ranking, propensity, explainability) and using them responsibly in production products., • A systems thinker who can simplify complexity and build products people actually use., • A pragmatic builder who delivers “thin slices,” learns fast, and iterates toward a durable platform., • An owner who takes accountability for outcomes, especially when the metric is dollars., • A trusted partner who can bridge finance, clinical, and technical teams. SALARY (BEFORE COMMISSION POTENTIAL): $140,000 - $160,000 Offer amounts for both remote and in office roles are influenced by geographic location. CYBERSECURITY AWARENESS NOTICE In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @___ email domain. We will never ask for bank details or deposits of any kind as a condition of employment. ABOUT RIGHTWAY: Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them. Since its founding in 2017, Rightway has raised over $205mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs. HOW WE LIVE OUR VALUES TO OUR TEAMMATES: We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values: Rightway is Proudly an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.