Sr. Product Manager | Pharmacy Payment Integrity

About this role

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.


Product Manager, Pharmacy Payment Integrity
Machinify is seeking a Product Manager to transform pharmacy payment integrity from manual workflows to AI-first automation. Own the product roadmap for AI agents, voice AI and IVR automation, intelligent data acquisition, automated payment/recovery workflows, and customer-facing analytics.


What You'll Do

• Agentic workflow automation: Design and ship AI agents that automate COB investigations, primacy determination, validation, claims tagging, and recovery handoff across Medicare, Medicaid, and commercial flows.
• Voice AI and conversational data acquisition: Replace legacy IVR/phone-based verification with AI-powered conversational workflows; integrate third-party insurance discovery APIs and PBM portal automation.
• Payment and recovery automation: Build end-to-end automation for bulk billing, auto-invoicing, denial recovery, and recovery submission workflows.
• Customer-facing analytics: Redesign the customer portal with real-time dashboards, SLA transparency, recovery pipeline visibility, and self-service reporting that crystallizes customer ROI
• AI agent capabilities: Define agent behavior, decision logic, human-in-the-loop handoffs, quality guardrails, and pilot-to-scale deployment plans.
• Operational transformation: Partner with operations teams to identify high-volume, low-complexity workflows ...