Develop and maintain advanced analytical models to support pricing and underwriting strategies within a healthcare context. Collaborate with business stakeholders and leadership to design pilots and deliver actionable insights that drive strategic objectives.
Coordinate fertility plans and medications by collaborating with patients and physicians while resolving customer issues. Accurately enter patient information, prescriptions, and insurance details into the system while maintaining high process efficiency.
Lead and develop a team of data scientists to build and advance predictive models for healthcare renewal risk estimation. Partner with cross-functional teams to deliver scalable analytical solutions that improve pricing and underwriting decision quality.
The specialist will resolve insurance claims, research denials, and manage the revenue cycle to ensure timely reimbursement. They will also communicate with patients and payers while documenting account activity and identifying trends for process improvement.
The Program Management Lead Analyst supports supply chain initiatives by managing product roadmaps, business cases, and cross-functional delivery. They act as a business product owner to drive rebate optimization and process improvements while monitoring KPIs and competitive trends.
Lead the strategy, development, and lifecycle management of machine learning models for pricing, underwriting, and risk scoring. Partner with cross-functional teams to embed analytical insights into business processes and ensure compliance with governance standards.
The Senior Benefit Advocate ensures client benefit intent is accurately translated from plan documents into configuration systems like Crystal and Diamond. They perform complex quality assurance, resolve benefit-related issues, and collaborate with cross-functional teams to ensure accurate implementation.
The Director is responsible for shaping and delivering digital product and engagement strategies across a portfolio to drive measurable business and customer value. They lead cross-functional teams and stakeholders to translate business priorities into actionable roadmaps and cohesive, data-driven customer experiences.
The Audit Specialist II facilitates the processing of audits by reviewing claim submissions for accuracy and identifying root causes of discrepancies. They are responsible for maintaining knowledge of state and federal guidelines while assisting in the development of standard operating procedures and training.
The analyst will assist Agile Product Owners in delivering enterprise initiatives and developing scope of work estimates for various operational platforms. They will also monitor operational backlogs, translate business rules into pathway algorithms, and provide subject matter expertise to cross-functional teams.
The Proposal Project Specialist manages the end-to-end proposal development process for custom bids, including research, writing, and cross-functional coordination. They also serve as a subject matter expert to ensure requirements compliance and contribute to ongoing process improvement initiatives.
Manage a portfolio of global health accounts by providing consultative support and driving renewals to meet business growth targets. Develop client management plans and resolve complex service issues to ensure high-quality client experiences and long-term partnerships.
The Senior Clinical Consultant supports provider engagement by analyzing pharmacy and medical data to develop evidence-based academic detailing strategies. They deliver customized education to prescribers to improve medication use, quality, safety, and affordability.
The Prior Authorization Representative manages the authorization process for home infusion and enteral services by submitting requests and coordinating with insurance plans. They also maintain clear communication with patients, prescribers, and internal teams to ensure timely care delivery.
The Vice President will develop and implement sales strategies for existing dental business to drive growth, retention, and product conversions. They will act as a liaison between the dental organization and national account executives to maximize opportunities and provide expert product positioning.
The role involves providing strategic and analytical support to the Payment Integrity team by evaluating clinical coding audits and recovery initiatives. You will translate complex data into actionable business insights and financial forecasts to drive enterprise affordability goals.
The incumbent will handle incoming precertification calls from healthcare professionals and third-party administrators while maintaining call center statistics. Responsibilities also include processing fax, mail, and web inquiries while ensuring accurate documentation and quality of service.
The staff pharmacist will perform remote medication order verification, clinical consultation, and transitions-of-care services across multiple hospital systems. They are responsible for evaluating prescriber orders for safety and efficacy while collaborating with healthcare teams to ensure optimal patient outcomes.
The Account Manager Support Specialist provides operational and project support to National Account Managers to ensure consistent client implementation and service. This role manages readiness issues, coordinates internal deliverables, and assists with reporting to allow NAMs to focus on strategic client management.
The staff pharmacist will perform remote order entry, drug verification, and provide clinical support to hospital care teams. They are responsible for documenting interventions, ensuring compliance with pharmacy laws, and maintaining high standards of patient care.
The Business Development Director will drive sales growth by developing pharma client strategies and leading cross-functional teams to deliver data-driven solutions. They are responsible for meeting revenue targets, managing C-suite relationships, and executing the global growth roadmap.
The Director will lead a software engineering team to build and scale the new PBM platform while ensuring engineering delivery aligns with enterprise standards. They are responsible for overseeing design, development, production readiness, and talent development within the assigned domain.
The Principal Test Architect defines and maintains the end-to-end test strategy, architecture, and quality governance for the New PBM Platform program. They provide technical leadership, establish automation standards, and ensure readiness evidence is produced across complex, integrated systems.
The role involves monitoring state government trends and legislation to support the company's business environment while representing interests to elected officials and regulators. Additionally, the principal will manage regulatory inquiries and collaborate with internal teams to provide government relations expertise for client support.
The Managing Director will define and execute technology strategy, product roadmaps, and engineering delivery for a portfolio of Corporate Functions, with an initial focus on Legal technology. They will lead the transition to product-oriented teams while partnering with senior leadership to drive innovation, modernization, and measurable business outcomes.
Prepare and review claims for billing accuracy, including verifying codes, modifiers, pricing, dates, and authorizations. Pursue reimbursement from patients and payors, resolve rejected claims, follow up on outstanding accounts, respond to billing inquiries, and assist with special projects.
The Customer Enablement Specialist manages the end-to-end customer lifecycle, including onboarding, account maintenance, and operational readiness. They act as a liaison between Sales and cross-functional partners to drive process improvements and ensure a seamless customer experience.
The Senior Analyst contributes to product direction, pricing, and budget analyses while identifying opportunities for brand exposure and operational efficiency. They are responsible for translating clinical criteria into pathway algorithms and maintaining program workflows and documentation.
Lead contract negotiations with health systems and ancillary providers to support network affordability and market goals. Build detailed financial models and maintain trusted relationships with providers to ensure long-term partnership success.
The Medical Executive serves as a strategic physician leader responsible for improving healthcare affordability and network performance through provider engagement and clinical leadership. They collaborate with cross-functional teams to implement value-based care initiatives and drive measurable outcomes in cost, quality, and utilization.
