The Compliance & Quality Analyst will support the organization's compliance, quality, accreditation, and regulatory activities by maintaining audit-ready documentation and monitoring program requirements. The role involves cross-functional collaboration to track workstreams, manage vendor oversight, and provide analytical support for legal and contracting initiatives.
The Clinical Pharmacist Manager leads the pharmacy team in reviewing clinical coverage determinations and appeals while ensuring accuracy and timeliness. They are responsible for hiring, coaching, and evaluating staff, as well as managing daily operations and cross-functional collaborations.
Support daily coverage determination and appeals workflows by processing cases, monitoring queues, reviewing work for accuracy and compliance, and helping resolve escalations. Maintain workflow documentation, communicate procedural updates, respond to stakeholder inquiries, and identify process gaps and improvements.
The Clinical Coordinator Supervisor leads and mentors the clinical operations team to ensure accurate and timely processing of coverage determinations and appeals. This role oversees daily operations, manages staff performance, and handles escalated clinical issues to maintain business objectives.
Serve as the primary clinical contact for self-funded employer clients, translating complex clinical and financial data into actionable pharmacy benefit strategies. Lead client-facing engagements including business reviews, strategic planning, and clinical escalations to improve pharmacy performance and member outcomes.
Lead strategic client relationships and day-to-day account services, including operational and clinical support, client meetings, benefit and claims inquiries, and onboarding coordination. Mentor client services staff, identify and escalate risks, and collaborate across teams to improve client experience and operational performance.
The Clinical Pharmacist reviews coverage determinations and appeals based on clinical guidelines and SlateRx protocols. They also provide drug information, handle physician outreach, and ensure accurate, timely decision-making for pharmacy benefit requests.
The Senior Analyst will support the Director of Underwriting by conducting financial analyses, managing RFP processes, and performing repricing exercises. They will also collaborate with cross-functional teams to monitor contract compliance and evaluate the financial performance of client deals.
The Clinical Coordinator supports clinical functions by managing coverage determinations and appeals, including creating case files and transcribing documentation. They are responsible for communicating with prescribers and members while configuring outcomes in the adjudication system.
The Manager of Underwriting supports RFP processes and conducts financial analyses to evaluate value propositions and contract compliance. They oversee repricing exercises, build complex financial models, and collaborate with cross-functional teams to drive organizational growth.
The Senior Proposal Strategist is responsible for creating compelling and accurate responses to RFPs and RFIs to secure new PBM partnerships. This includes conducting research, managing the proposal database, and collaborating with cross-functional teams to meet submission deadlines.
The Manager of Underwriting supports RFP processes and conducts financial analyses, including repricing exercises and value proposition assessments for clients. They collaborate with cross-functional teams to monitor contract compliance and develop financial scorecards for strategic planning.
The Senior Proposal Strategist is responsible for creating compelling and accurate responses to RFPs and RFIs to secure new PBM partnerships. This includes conducting research, managing the proposal database, and collaborating with cross-functional teams to meet submission deadlines.
