Note: The job is a remote job and is open to candidates in USA. Carrot is the leading global fertility and family care platform, and they are seeking a Sr. Strategic Programs Manager to shape the future of fertility reimbursement and pharmacy solutions. This role involves leading operational strategies, developing reimbursement capabilities, and managing partnerships to drive growth and improve member experiences.
Responsibilities
- Lead the operational strategy and day-to-day management of Carrot Rx, including strategic pharmacy partnerships, reimbursement strategy, pricing updates, benefit design, and program governance
- Develop and support Carrot's claims-based billing strategy, partnering across Product, Engineering, Finance, Provider Partnerships, and Commercial to build scalable reimbursement capabilities
- Manage relationships with pharmaceutical manufacturers, specialty pharmacies, PBMs, provider organizations, and health plans to strengthen Carrot's reimbursement ecosystem
- Support payer integrations, reimbursement methodologies, coding governance, and claims adjudication strategies that improve member and customer experiences
- Develop financial models, business cases, dashboards, and operational reporting that support reimbursement strategy, pricing decisions, commercial opportunities, and executive decision making
- Analyze reimbursement, utilization, provider, pharmacy, and health plan performance to identify opportunities for cost optimization, network improvements, and operational efficiencies
- Partner with Commercial on customer implementations, RFPs, RFIs, performance guarantees, and strategic customer opportunities requiring reimbursement expertise
- Lead cross-functional initiatives from concept through implementation while aligning stakeholders 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
Skills
- A 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
- The ability to balance strategic thinking with hands-on execution in a fast-paced, evolving environment
- A collaborative mindset with a passion for improving healthcare through innovative solutions
- Experience supporting claims-based billing, reimbursement strategy, or payer integration initiatives
- Knowledge of fertility benefits, reproductive healthcare, pharmacy benefit management (PBM), specialty pharmacy, or women's health
- Familiarity with provider reimbursement methodologies, CPT, HCPCS, diagnosis coding, and health plan claims processing
- Experience supporting commercial strategy, customer implementations, RFPs, RFIs, or consulting engagements
- Strong analytical skills with experience using SQL, Excel, Google Sheets, Tableau, Looker, or other healthcare analytics tools
- Experience working with pharmaceutical manufacturers, specialty pharmacies, PBMs, or provider organizations
Benefits
- Competitive compensation, equity, and comprehensive benefits.
- Flexible Time Off and a culture that actively encourages employees to recharge.
- Comprehensive parental leave and family-forming benefits.
- Health and wellness benefits
- Retirement savings plans
- Short- and long-term incentives
- Parental leave
- Family-forming assistance
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