Sr. Strategic Program Manager

18 minutes ago
Full-time
Senior
Project and Program Management
Carrot Fertility

Carrot Fertility

Carrot Fertility provides comprehensive global fertility benefits for employers, facilitating access to a wide range of fertility care services, including egg and sperm freezing, IVF, gestational surrogacy, and adoption, while offering personalized sup...

Insurance
251-1K
Founded 2016
$114M raised

Description

  • Lead the operational strategy and day-to-day management of Carrot Rx, including pharmacy partnerships, reimbursement strategy, pricing updates, benefit design, and program governance.
  • Develop and support Carrot’s claims-based billing strategy in partnership with Product, Engineering, Finance, Provider Partnerships, and Commercial.
  • Manage relationships with pharmaceutical manufacturers, specialty pharmacies, PBMs, provider organizations, and health plans.
  • Support payer integrations, reimbursement methodologies, coding governance, and claims adjudication strategies.
  • Develop financial models, business cases, dashboards, and operational reporting for reimbursement strategy, pricing decisions, and executive decision making.
  • Analyze reimbursement, utilization, provider, pharmacy, and health plan performance to identify cost optimization and operational efficiency opportunities.
  • Partner with Commercial on customer implementations, RFPs, RFIs, performance guarantees, and strategic opportunities requiring reimbursement expertise.
  • Lead cross-functional initiatives from concept through implementation across Product, Clinical Operations, Finance, Engineering, Provider Partnerships, Business Intelligence, Customer Success, and Commercial.
  • Identify opportunities to improve operational processes through automation, analytics, and scalable program design.
  • Serve as the subject matter expert for Carrot Rx and claims-based billing across the organization.

Requirements

  • Bachelor’s degree.
  • 5+ years of experience in healthcare strategy, payer operations, reimbursement, pharmacy, provider contracting, healthcare analytics, consulting, or a related field.
  • Experience working with health plans, employer-sponsored benefits, provider reimbursement, pharmacy benefit programs, or healthcare payment models.
  • Strong analytical and strategic problem-solving skills with the ability to translate complex healthcare topics into actionable business recommendations.
  • Experience leading complex cross-functional initiatives involving multiple stakeholders.
  • Excellent communication, stakeholder management, and project management skills.
  • Ability to balance strategic thinking with hands-on execution in a fast-paced, evolving environment.
  • Collaborative mindset with a passion for improving healthcare through innovative solutions.
  • Experience supporting claims-based billing, reimbursement strategy, or payer integration initiatives (preferred).
  • Knowledge of fertility benefits, reproductive healthcare, PBM, specialty pharmacy, or women’s health (preferred).
  • Familiarity with provider reimbursement methodologies, CPT, HCPCS, diagnosis coding, and health plan claims processing (preferred).
  • Experience supporting commercial strategy, customer implementations, RFPs, RFIs, or consulting engagements (preferred).
  • Strong analytical skills with experience using SQL, Excel, Google Sheets, Tableau, Looker, or other healthcare analytics tools (preferred).
  • Experience working with pharmaceutical manufacturers, specialty pharmacies, PBMs, or provider organizations (preferred).

Benefits

  • Competitive base salary of $145,000-$160,000.
  • Competitive compensation, equity, and comprehensive benefits.
  • Health and wellness benefits.
  • Retirement savings plans.
  • Short- and long-term incentives.
  • Parental leave and family-forming assistance.
  • Flexible Time Off.
  • A collaborative, inclusive, and values-driven culture.

Interested in this position?

Apply directly on the company website

Apply Now

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