• Cumberland, RI

Lead, mentor, and develop a team of Accounting professionals. Design and implement key controls over Rebate accounting, receipts, and payments. Evaluate reserves and recommend adjustments. Streamline and automate processes.

• Woonsocket, RI

Accountable to formulate / define system scope and objectives to meet project deliverables, ensuring that established timelines and cost estimates are maintained.

• 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.

• Corona, CA

Supervise store crew, communicate effectively with store management, and handle customer service issues. Must have deductive reasoning ability, analytical skills, and flexibility in schedule. Retail experience preferred.

• TN, VA, NY, MA, MD, NC, CT, NJ, PA, RI, DE

Lead the sales process for PBM and clinical programs in the Health Plan segment, including financial input, contract negotiations, and building relationships with key prospects. Mentor colleagues and contribute to team calls. Must reside in the Northeast.

• WA

Assist with establishing and implementing results-based programs and innovative initiatives for the network operations area, under general supervision. Collaborate internally and cross-functionally to support initial negotiations and re-negotiations...

• 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.

• 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

• RI, NY, TX, GA

Manage day-to-day operations for Commercial Accountable Care Act (ACA) Prospective Programs. Ensure timely reconciliation of claims for encounter submission deadlines and deliver advice to the organization regarding current business trends and best p..

• Woonsocket, RI

Collaborates with business and technical partners to develop functional area product strategy and roadmap, including the established list of priorities for Colleague Experience.

• MI

Negotiate, execute, and analyze contracts with large hospital systems and physician groups. Manage contract performance and develop strategic relationships to expand provider networks. Identify cost-saving initiatives and ensure provider needs are met.

• MI

Constructs negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers. Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

• Raleigh, NC

Our Heart At Work Behaviorist support this purpose. We want everyone who works to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal...

• 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 ..

• 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.

• TX

Coordinate and oversee Specialty Benefits Implementations and Maintenance workflow. Consult on operational improvements for Specialty client support. Collaborate with cross-functional partners for design and contractual changes. Develop a culture of ..

• Providence, RI

Provide user support for workflow applications, assist with project management and process mapping, create and maintain documentation, and collaborate with internal partners to assess processes and recommend improvements.

• FL

Provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. support the Medical Management staff ensuring timely and consistent responses to members and providers.

• FL, NC

Provide oversight for medical policy implementation, participate in the development and evaluation of clinical programs, support medical management staff, and provide clinical expertise and business direction.

• OH

Expands medical management programs, oversees utilization review/quality assurance, and provides clinical expertise and business direction. Collaborates with CMO and acts as a liaison to network providers and facilities.

• 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.

• 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..

• 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.

• 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..

• 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..

• 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.

• 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.

• US National

Design, implement, and maintain ServiceNow Discovery solutions. Configure and optimize ServiceNow Discovery to identify assets and configuration items. Collaborate with cross-functional teams for integration and continuous improvement.

• 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..

• Pittsburgh, PA, Buffalo Grove, IL, Woonsocket, RI, Hartford, CT, Irving, TX

Develop clinically and ethically based content for drug coverage programs, participate in interpretation, review and development of content supporting client specific and standard drug coverage programs, and train new or existing UM pharmacists on pr..

• 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..

• 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.

• 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..

• 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...

• 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 ..

• PA, DE, WV

Provide oversight for medical policy implementation, develop and evaluate clinical programs, and support medical management staff. Focus on utilization review/quality assurance and provide clinical expertise and business direction to support medical ..

• IL

Interacts directly with patients, physicians, caregivers, and internal departments to answer questions, solve problems, provide education, and maintain our companys reputation for high-quality service.

• AZ, TX, OK, VA, IL, PA, CA

Analyze financial performance, review contract terms, and provide pricing recommendations. Collaborate with various departments to manage short- and long-term projects effectively. Create reporting packages and presentations for management.

• FL

Lead Long-Term Services and Support program, aligning with business strategies and regulations. Manage staff, develop workforce, and meet quality and compliance objectives. Implement Health Services strategies, policies, and programs.