The Account Executive is responsible for managing assigned accounts, including onboarding, renewals, and driving growth while ensuring client satisfaction. They act as the primary point of contact for employer administrators and collaborate with internal teams to deliver high-quality service.
The Director oversees the development and management of insurance networks, focusing on contract negotiations with major health systems and physician groups. They are responsible for optimizing network performance, managing provider relationships, and ensuring compliance with regulatory standards.
The actuary will own the end-to-end pricing mechanics for the company's self-funded ASO and stop loss product lines. This includes managing rating methodologies, state filings, experience studies, and collaborating with cross-functional teams to drive growth and profitability.
You will serve as the technical owner of the provider network platform, managing data ingestion, matching logic, and real-time payment authorization. You will also build and maintain AI agents to streamline operational workflows while ensuring high system availability and data integrity.
You will own the end-to-end growth platform, managing the marketing site, lead capture, and underwriting systems while integrating AI agents to automate workflows. You will collaborate directly with marketing, sales, and product teams to drive funnel performance and ship production-ready software.
The engineer will be the technical owner of the Finance and Accounting platform, focusing on data-intensive applications and the automation of manual processes using AI agents. Responsibilities include owning the full-stack codebase, managing data pipelines, and partnering with F&A stakeholders to translate workflows into software.
Oversees the development and management of insurance networks to improve affordability and quality outcomes. Manages complex contract negotiations with health systems and physician groups while maintaining strategic provider partnerships.
Own the end-to-end security engineering function, including platform strategy, detection and response, and application security. Lead the design and implementation of AI-powered security tooling and maintain the organization's AWS security posture.
Oversees the development and management of insurance networks in the Midwest Region to improve affordability and quality outcomes. Manages contract negotiations with large physician groups and ancillary providers while maintaining strategic provider partnerships.
Lead network development and provider contracting for the Southwest region to ensure competitiveness with larger health plans. Manage critical provider relationships and align network strategy with company growth and profitability objectives.
Lead the development and execution of enterprise account strategies to maximize client retention and satisfaction for large employer groups. Manage the end-to-end implementation process and collaborate with internal teams to align product offerings with market demands.
Architect and own a real-time benefits management platform using an AI-first development approach. You will manage the full lifecycle from product discovery and stakeholder collaboration to production uptime and operational metrics.
The Account Executive is responsible for the onboarding, renewal, and growth of assigned employer accounts while ensuring high client satisfaction. They serve as the primary contact for employer administrators and collaborate with internal teams to deliver seamless healthcare services.
Perform prior authorization reviews and coverage determinations for high-cost specialty medications covered under medical benefits. Support the development of medical drug policies, utilization management strategies, and Pharmacy & Therapeutics Committee activities.
The Senior Accountant will manage advanced month-end close activities, financial reporting, and account reconciliations. They will also conduct in-depth financial analysis and collaborate with cross-functional teams to improve accounting processes.
Design, deploy, and maintain cloud infrastructure and CI/CD pipelines to improve developer productivity. Own the full lifecycle of services and subsystems while ensuring fault tolerance and HIPAA compliance.
Lead and execute a comprehensive information security and IT strategy, serving as the HIPAA Information Security Officer. Oversee GRC, security operations, and enterprise IT infrastructure to support a growing AI-driven healthcare organization.
Negotiate and maintain agreements with vendors and national providers while streamlining contracting support processes. Serve as the primary network focal point for internal departments and manage provider termination and credentialing agreements.
The role focuses on providing Tier 2/3 technical support while building AI-driven automation to modernize help desk operations. It involves optimizing onboarding/offboarding processes and reducing manual effort through scalable service delivery systems.
The analyst ensures payment accuracy by identifying and coordinating benefits across multiple payers to prevent improper payments. They interpret COB rules, resolve complex claim issues, and collaborate with recovery and vendor management teams to reduce waste.
The engineer will serve as the technical owner of the care coordination platform, managing the full-stack codebase and production infrastructure. They will collaborate directly with clinical stakeholders to translate operational needs into shipped software using an AI-first development approach.
Oversees the development and management of insurance networks to improve affordability and quality outcomes. Manages complex contract negotiations with hospitals and providers while maintaining strategic partnerships in the West region.
The Director provides strategic leadership for network management and contracting, overseeing negotiations with major health systems and physician groups. They are responsible for managing a team of negotiators, ensuring unit cost targets are met, and fostering strong provider partnerships.
The Director of Network Development oversees the creation and management of insurance networks in the South East Region to improve affordability and quality outcomes. This role involves negotiating complex provider contracts, building strategic partnerships, and collaborating cross-functionally to optimize network performance.
The Installation Manager oversees the post-sale implementation process for new and renewal business, ensuring all setup milestones are met. They also serve as a subject matter expert to resolve group and broker escalations while maintaining accurate client records.
The role involves monitoring prescription claims rejections from third-party pharmacies, contacting members and providers with rejection information, and offering alternative options. Responsibilities also include working with the prior authorization team, evaluating requests, processing overrides in the JUDI system, and acting as a Subject Matter Expert on pharmacy and drug benefits.
The Junior Actuary will assist with developing pricing strategies, refining underwriting guidelines in collaboration with senior actuaries, and analyzing company data to support pricing and strategy decisions. Responsibilities also include calculating group rates, contributing to executive reports, and maintaining communication with internal teams on various actuarial projects.
This role involves formulating and implementing management policies and operational practices to enhance organizational efficiency, while also leading major assignments impacting the organization's operations. The analyst will provide expert consultation to management and be actively involved in strategic planning and resolving significant operational issues.
This pivotal role involves overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations for healthcare services. The Medical Director will act as a key clinical expert, ensuring appropriate resource utilization, promoting evidence-based care, and leading peer-to-peer discussions with practitioners.
This role involves leading negotiations with large physician groups and ancillary providers, simultaneously managing several contract negotiations to meet growth demands. Key duties include nurturing provider partnerships, maintaining communication with matrix partners, and being responsible for meeting unit cost targets while preserving an adequate network.
The specialist manages contract negotiations with physicians and physician groups, simultaneously conducting multiple negotiations to meet growth demands while nurturing provider partnerships. Responsibilities include meeting unit cost targets, improving medical cost and quality, and analyzing the financial impact of complex provider contracts.
The Actuary Manager will apply mathematical and statistical knowledge to support technical functions like rating, pricing, valuation, reserving, and financial forecasting for the health plan. Key duties include building and testing actuarial models, creating monthly reports, developing customized pricing models, and ensuring reserve adequacy through frequent monitoring.
This role is responsible for leading the strategic development, competitive positioning, and operational management of the provider network across the Mid Atlantic Region, ensuring coverage and unit costs are highly competitive against larger health plans. Key functions include leading complex negotiations, managing critical provider relationships, ensuring regulatory compliance, and aligning network strategy with growth and profitability goals.
The Staff Physician will provide high-quality, evidence-based care to members via telehealth by independently assessing, diagnosing, and treating acute conditions using an advanced AI-assisted clinical framework. Responsibilities also include providing clinical feedback to refine workflows and collaborating to ensure seamless member transitions into other health plan programs.
This role involves leading direct financial negotiations with hospitals to secure fair cash-pay rates for high-cost procedures and auditing hospital estimates for coding accuracy, ensuring alignment with clinical necessity. The lead will also review clinical trial protocols to differentiate between sponsor-covered research costs and Standard of Care costs that the health plan should cover.
