The Compliance Specialist will support the organization's compliance program through regulatory research, monitoring, and documentation management. They will collaborate with cross-functional teams to ensure regulatory requirements are implemented and tracked across the business.
The Audit Manager is responsible for leading and managing the organization's comprehensive audit program, ensuring readiness for regulatory, client, and internal audits. This role coordinates audit execution, manages evidence, tracks findings, and partners with cross-functional teams to implement corrective actions.
The Data Governance Analyst is responsible for establishing and maturing the organization's enterprise data governance framework and policies. This role collaborates with cross-functional teams to ensure data quality, consistency, security, and compliance across all business and technology platforms.
The Data Analyst will collect, analyze, and interpret large datasets related to health insurance claims to identify trends and inform business decisions. Responsibilities include building PowerBI dashboards, creating client reports, and collaborating with cross-functional teams to support business goals.
The Director of Networks & Underwriting leads pharmacy network strategy, performance management, and underwriting capabilities to ensure financially sound pharmacy benefit solutions. This role involves collaborating with cross-functional teams to develop competitive proposals, manage contractual guarantees, and oversee financial modeling.
The Prior Authorization Coordinator manages the review and processing of pharmacy prior authorization requests through various channels. They ensure compliance with benefit plan parameters and provide support to members, pharmacies, and physician offices.
The Prior Authorization Coordinator manages the review and processing of pharmacy prior authorization requests via electronic, fax, or manual channels. They are responsible for verifying documentation, coordinating with pharmacists for clinical reviews, and communicating status updates to members and providers.
The Data Engineer designs, builds, and maintains cloud-native data platforms and integration pipelines within Microsoft Azure. This role ensures secure and reliable data exchange between internal applications, external partners, and analytics systems.
The Director of Cost Containment provides strategic leadership for the cost containment portfolio, ensuring programs deliver measurable value and clinical outcomes. This role oversees program administration, technology integration, and cross-functional collaboration to optimize savings and operational efficiency.
Act as a senior liaison to drive business growth by ensuring client renewal and retention through strategic account leadership. Coordinate with internal teams to analyze claims data, identify cost-saving opportunities, and oversee the onboarding of new clients.
