Senior Director (Specialty Benefits Programs)

Senior Director, Specialty Benefits Programs (AI-Native Healthcare Start-Up)
$185,000 - $230,000 + Equity + Benefits
Remote, US

Are you a healthcare product leader who's owned a program from design through live operation, negotiating vendor contracts and building the operating model along the way? Have you navigated the operational maze of self-funded employers, TPAs, and utilization management partners to bring a benefit program to life?

This is an opportunity to join a fast-growing healthcare services startup that redirects expensive, hospital-based specialty infusion therapy (for conditions like Crohn's, MS, and cancer support) into more convenient, lower-cost home or clinic settings. Through dedicated Care Guides and transparent, pass-through pricing, the company cuts employer drug spend by 40-50% while improving the patient experience. It already partners with some of the largest blue-chip employers and serves well over 1 million patients.

Now aiming to 5-10x that volume, the company is hiring a Senior Director of Specialty Benefits Programs to design and operate the programs that make it a seamless, preferred pathway for lower-cost, high-quality specialty drug and infusion care. You'll define how each program works in practice, build or contract for the capabilities it needs, and take it live, working closely with Sales, Legal, Clinical Affairs, Operations, and Client Success.

If you want to build this capability at an early stage and shape how it scales as the company grows from 50 to 80 people this year and approaches 5 million served patients, this is an outstanding opportunity to turn complex benefit and operational requirements into models that work across clients whilst benefiting from the upside in rapidly scaling HealthTech.

The Role

• Own the design and evolution of Leap's specialty benefit programs, formalizing plan terms and clinical criteria
• Translate business and client requirements into clear product, operational, and partner specs
• Identify the capabilities and partnerships needed, and decide when to build versus partner externally
• Evaluate, select, negotiate, and contract with enabling partners like TPAs and utilization management organizations, owning renewals and renegotiation once live
• Establish the operating model, including prior auth workflows and escalation paths
• Track performance across engagement, utilization, and savings, using the data to build repeatable models that scale across clients
• Develop customer segmentation and TAM to prioritize which program configurations to build
• Serve as the product and technical subject matter expert in prospect and client conversations

The Person

• Has owned a healthcare product or offering from design through implementation and live operation
• Experience working directly with self-funded employers and TPAs
• Skilled at identifying capability gaps and building or contracting for solutions
• Direct experience evaluating vendors and negotiating commercial terms
• Able to make product and operational tradeoffs balancing member experience, client savings, and operational feasibility
• Comfortable serving as the product and technical expert in sales and client conversations
• Bonus: understanding of healthcare benefit design and utilization management, or experience with specialty drugs, infusion therapy, buy-and-bill, or site-of-care programs

Rise Technical Recruitment Inc of 1011 Centre Rd, Suite 322, Wilmington, DE 19805 act as an employer-paid private personnel agency.

The salary advertised is the bracket available for this position. The actual salary paid will be dependent on your level of experience, qualifications and skill set and will be decided by our client, the employer. Rise are not responsible or liable for any hiring decisions made by the end client.

We are an equal opportunities company and welcome applications from all suitable candidates.