• LA, AR

Manage relationships with assigned providers, optimize interactions, monitor service capabilities, educate providers, and conduct provider recruitment and contracting activities. Bachelor's degree preferred with 3 years of experience in business segm..

• Woonsocket, RI

Develop dashboards, tools, and processes to deliver actionable insights to leadership. Gather and analyze data to create executive reports. Communicate key findings to cross-functional teams and senior leadership.

• VA

Develop and implement account management strategies, maintain strong customer relationships, achieve revenue and earnings objectives, create demand and raise profile with customers, assess competitive environment, and develop sales strategies.

• ME, WI, VT, NY, IL, MA, NJ, PA, CT, NH, RI, MI

Use clinical and analytical skills to positively impact clients' health while reducing healthcare costs. Serve as a clinical expert on the account team, analyze drug utilization patterns, deliver reporting, educate clients on clinical programs, and m..

• Hartford, CT

Design, implement, and maintain automated workflows and processes for public cloud governance. Develop governance frameworks for managing cloud resources, access controls, and cost optimization. Collaborate with teams to integrate cloud automation so..

• Fairfield, NJ

Ensure accuracy in pharmaceutical dispensing, provide customer service to patients and healthcare professionals, and provide leadership and guidance to supporting staff as a pharmacist in a specialty mail order pharmacy...

• Nashville, TN

Lead team-members through engineering of IAM solutions, coordinate IAM team's work and keep projects on schedule, manage implementations and releases via CI/CD strategies, influence and align key stakeholders.

• CO

Lead Backend Node Developer responsible for providing technical leadership and guidance to the digital engineering team, researching and evaluating emerging technologies, designing and implementing complex features, and troubleshooting technical chal..

• NY

Automate IT processes and develop solutions to enhance system monitoring, alerting, and reporting capabilities. Manage source code and version control using GitHub. Collaborate with cross-functional teams to streamline processes and troubleshoot issues.

• TX

Lead process optimization, analysis, and improvement initiatives, utilizing Six Sigma, Agile, and Lean methodologies. Collaborate with cross-functional teams to streamline workflows, implement digital tools, and ensure compliance with organizational ..

• Phoenix, AZ, or US National

Formulate pricing strategy and execute financial modeling. Collaborate with sales and account services to provide recommendations on pricing and negotiation strategy. Develop and maintain domain expertise in PBM and enterprise profitability.

• TX

Lead Director responsible for managing provider contracts, negotiating high-value contracts with complex providers, managing contract performance, identifying cost-saving initiatives, and collaborating cross-functionally to achieve network expansion ..

• Columbus, OH

Provide telephone-based consultation and counseling services to members, including crisis intervention, lifestyle management, and counseling sessions. Collaborate with a team of professionals and maintain compliance with policies and regulatory standards.

• Hartford, CT

Lead cloud engineering and automation teams to deliver innovative cloud-based solutions aligned with business goals. Develop cloud strategy, oversee cloud engineering management and automation, and foster team leadership and development.

• Harrisburg, PA

Lead Solution Architect responsible for developing business, application/integration, data, infrastructure, platform, and security architectures. Collaborate with various teams to create solution architectures for key strategic initiatives and delive..

• RI

Manager specializing in strategic data analyses to support key business decisions for the PBM line of business. Use data-driven insights to develop winning business strategies and enhance existing solutions. Strong expertise in financial modeling, da..

• Bloomington, MN, Downers Grove, IL

Lead discussions and negotiations for high-value rebate contracts with pharmaceutical manufacturers. Develop and foster strong relationships with direct manufacturers and industry partners. Coordinate with key leaders responsible for pharmacy benefit..

• Buffalo Grove, IL

Lead the Business Continuity and Crisis Management programs, including managing teams, developing business continuity plans, measuring progress against industry standards, and ensuring compliance to maintenance requirements.

• RI, TX, IL

Lead strategic account team to deliver solutions, client satisfaction, and service delivery. Influence client up-sell opportunities through consultative selling skills. Develop and deliver quarterly and annual reporting to clients on drug trend and f..

• Hartford, CT

Design, develop, and maintain automated solutions for database deployment, configuration, backup and recovery, monitoring, and performance tuning. Collaborate with software development teams to integrate database automation process. Troubleshoot and ..

• Chandler, AZ

By assimilating health/nutritional assessment data analysis, establishes a plan of care based on members health status/risks, education, and support needs. Partners with members to identify opportunities for integration into available internal/external..

• Cumberland, RI

Design, develop and maintain automated solutions for Open Source and Oracle database deployments, configuration, backup and recovery, monitoring and performance tuning.

• Springfield, IL

Rebate Forecast Contract Advisor interprets rebate contracts, maintains tools, collaborates with internal partners for market competitive rebate offers, and updates forecast model inputs. Financial analysis and advanced Excel skills preferred.

• Providence, RI

Identify and manage operational KPIs, establish partnerships, develop automation solutions, investigate incidents, provide coaching, and stay current with emerging technologies. 7+ years of SRE, Engineering, or Operations experience required.

• PA

Pharmacist responsible for providing exceptional customer service, accurate delivery of pharmaceutical care services, and leadership to supporting staff. Requires pharmacy experience and active licensure as a practicing pharmacist in Pennsylvania.

• Harrisburg, PA

Lead a team of database administrators to design, implement, and maintain secure, stable, and performant database servers and technologies. Provide 24/7 support for production issues and ensure compliance with security standards.

• Woonsocket, RI

Support the execution of production events at corporate headquarters. Responsible for AV support in conference rooms, town halls, and leader events. Troubleshoot AV equipment and manage calls on WebEx and Microsoft Teams.

• Lansing, MI, Phoenix, AZ, Richmond, VA, Southfield, MI, Anchorage, AK, Hartford, CT, High Point, NC, Amherst, NY, Chicago, IL, San Antonio, TX, Franklin, TN, Jacksonville, FL, Atlanta, GA, Scottsdale, AZ, Wellesley, MA, Plymouth, MN

Act as an important liaison and subject matter expert between our internal and external stakeholders and the stop loss administrators. Ability to work independently across a matrix team in a fast-paced environment

• San Antonio, TX

Provides clinically relevant information as is necessary and as it pertains to the translating, dispensing, and shipping of prescription medication through communication with members and/or health care professionals.

• CT

"Lead cross-functional team to review and analyze incidents, implement action plans, and prevent future occurrences. Ensure scalability, performance, resiliency, and stability of key applications during critical peak periods."

• Cumberland, RI, Moon Township, PA, Scottsdale, AZ, Hartford, CT, Chicago, IL, Blue Bell, PA, Downers Grove, IL

Support leaders and employees with advice on company policies, manage workplace inquiries, provide coaching, corrective actions, and terminations. Collaborate with stakeholders to promote positive employee relations.

• Cumberland, RI, or US National

Managing litigation against the company, overseeing outside counsel, developing litigation strategy, assessing case value, reviewing pleadings, providing reporting on case developments, and participating in mediation and trial.

• US National

Architect, design, and support complex voice and contact center solutions. Engineer fault-resilient multi-vendor solutions. Stay current with technology trends. Collaborate and drive effective partnerships across enterprise technology functions.

• Richmond, VA

Oversee Medicaid Provider Experience programs, maintain provider risk management and positive relationships, drive implementation of solutions for provider satisfaction, cost targets, network growth, and efficiency targets.

• Providence, RI

Develop, implement, mature, and manage financial operations procedures. Ensure adherence to financial and accounting principles. Provide expertise in financial software and tools. Strong written and verbal communication skills required.

• Hartford, CT

Design, build, deploy, and scale ML models using cloud-native containerization & distributed computing. Optimize ML pipelines for scalability and performance. Upgrade and maintain ML platform, mentor junior engineers.

• CA

Assist in resolving rejected clinical claims management. Make phone calls to insurance plans, work with local pharmacies to ensure timely dispensing of medications, and gather information for overrides/prior authorizations.

• Monroeville, PA

Supervise staff in the Benefits Verification Department, analyze call/performance statistics, coordinate procedural changes, evaluate and review team progress, and support management team in interviewing and hiring.

• Miami, FL

Assess, plan, and implement care management strategies for members enrolled in the Long-Term Care Program. Collaborate with providers and community resources to address members' health and social determinant needs. Advocate for members to ensure nece..

• US National

Develop, implement, and promote strategies, policies, and programs for healthcare delivery. Oversee behavioral health activities, educate providers, improve clinical outcomes, and integrate behavioral health and physical health.

• US National

Architect, design, and support complex voice and contact center solutions. Engineer fault-resilient multi-vendor solutions. Stay current with technology trends. Collaborate across enterprise technology functions to maximize alignment, efficiency, and..

• Chandler, AZ

Assess, plan, implement, and evaluate members' nutritional status. Develop and monitor nutrition plans, educate and support members to achieve optimal health. Utilize clinical guidelines/criteria and motivational interviewing skills to positively imp..

• NC

Lead and coordinate projects across Agile and Waterfall frameworks, ensuring operational excellence, process improvement, stakeholder management, and reporting and documentation. Requires strong project management skills and experience with Six Sigma..

• Buffalo Grove, IL, Hartford, CT, Woonsocket, RI, Chicago, IL, Dallas, TX, Irving, TX, Providence, RI, Worcester, MA, Pittsburgh, PA

Oversee development, maintenance, and execution of Traditional utilization management programs. Partner in a matrix relationship with colleagues at all levels and teams. Manage multiple complex, ongoing projects and meet timelines for critical delive..

• US National

Lead end-to-end proposal activities for large, complex Medicaid proposals. Ensure high engagement and collaboration across internal and external teams, adhere to established processes, and produce high-quality, compliant proposal responses.

• CT, OH, TX, FL, PA, UT

Learning rework queues, working rework reports, researching and troubleshooting failed claims, adding and editing overrides in RxClaim, logging audits and errors, identifying trends for process improvement, and raising issues to management.

• OH

Handle all intakes for any state escalations on member issues. Field and coordinate responses for state member escalations. Coordinate and facilitate meetings with internal and external stakeholders regarding PRTF services. Serve as the point of cont..

• MN

Perform routine quality audits for network operations and claim testing for PPO Network creation. Analyze data, identify errors, and develop quality programs to continually deliver quality service to internal and external customers.

• Hartford, CT

Perform complex analytics and reporting to identify and prioritize members for prospective and retrospective programs, optimize risk scores while maintaining compliance, build reports and dashboards to track risk adjustment programs, and collaborate ..

• Cumberland, RI

Design, develop, and maintain automated solutions for Open Source and Oracle databases. Collaborate with software development teams to integrate database automation. Propose innovative solutions for process improvement and automation in the database ..