Job Description

What You’ll Own

In this role, you will:

• 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.

What Success Looks Like

In your first 12–18 months, you will have:

• Successfully assumed operational ownership of Carrot Rx and established scalable processes supporting pharmacy partnerships, pricing, reporting, and program governance.
• Supported the continued development and implementation of Carrot's claims-based billing strategy and reimbursement capabilities.
• Built strong relationships with internal stakeholders and external partners, becoming a trusted advisor on reimbursement strategy and pharmacy operations.
• Improved operational efficiency through enhanced reporting, automation, and financial analyses that support data-driven decision making.
• Supported successful customer implementations, commercial opportunities, and strategic payer partnerships requiring reimbursement expertise.
• Developed financial models and business cases supporting provider contracting, pharmacy partnerships, and future product initiatives.
• Helped identify and implement opportunities that improve reimbursement performance, customer value, and long-term program scalability.

About You ✨

You likely have:

• 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.

Nice to Have ⭐

While not required, we would be especially excited if you bring:

• 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.

Why This Role Matters

Carrot is redefining fertility and family-building benefits by making high-quality, personalized care more accessible around the world. As Carrot continues to expand its partnerships with employers, health plans, providers, and pharmacy organizations, scalable reimbursement programs and innovative pharmacy solutions are becoming increasingly important to our long-term success.

This role sits at the intersection of strategy, healthcare reimbursement, analytics, and operations. The work you do will directly influence how Carrot designs new products, supports customers, strengthens pharmacy and provider partnerships, and delivers a seamless experience for members. By helping build the future of Carrot Rx and claims-based billing, you'll play a critical role in expanding access to fertility care while driving meaningful business growth and operational excellence across the organization.

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