Source Job

• Supports the strategy and execution of US Public Affairs activities, with a focus in cystic fibrosis.
• Monitors state legislation and identifies substantive policy and political opportunities and risks to the company’s business.
• Develops plans, goals, processes, and logistics for projects, gaining cooperation and alignment.

Vertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. Vertex is consistently recognized as one of the industry's top places to work, with global headquarters in Boston's Innovation District and international headquarters in London.

• Lead population-based market access strategy, integrating payer, provider, and health system perspectives into cohesive client recommendations.
• Architect decision maker engagement strategies that shape access across payer organizations, IDNs, and other organized customers.
• Translate healthcare policy, reimbursement trends, and stakeholder dynamics into forward-looking strategic frameworks and content platforms.

The Klick Group focuses on realizing the full potential of people and clients in life sciences. They have offices in New York, Philadelphia, Saratoga Springs, Toronto, London, São Paulo, and Singapore and are committed to fostering a high-performance, people-first culture.

• Serve as the MSD team's primary subject matter authority on ACA/Patient Protection and ACA (PPACA) policy, regulation, and CCIIO program operations.
• Lead development and maintenance of the MSD knowledge base, ensuring accuracy and currency of articles and related materials.
• Design and deliver Marketplace domain training and mentorship for MSD Customer Service Representatives and Senior Analysts onboarding and annually for plan year refreshers.

Computer World Services (CWS) is pursuing the CMS Marketplace Service Desk (MSD) opportunity. They are committed to the full inclusion of all qualified individuals and provide reasonable accommodations to individuals with disabilities.

• Accountable for the development and maintenance of clinical and reimbursement policies, ensuring alignment with CMS regulations.
• Serve as the authority on Medicare guidelines, specifically interpreting and operationalizing NCDs, LCDs, and national coding guidelines.
• Lead the implementation of AI initiatives to automate the monitoring of reimbursement policies.

Clover Health focuses on improving the health of its members by leveraging technology and data-driven insights to provide personalized, high-quality care. They aim to empower their members by helping them navigate the complexities of healthcare and live healthier lives and are passionate about making healthcare easier, more affordable, and more accessible for everyone.

• Oversee and implement pricing strategy for PBM opportunities.
• Drive full pricing process for traditional and pass through PBM RFP opportunities.
• Communicate range of pricing scenarios/options to internal stakeholders.

VytlOne is an independent, fully integrated total pharmacy solutions partner, offering mission-driven hospitals, health systems, health centers, and employer partners a way to unlock revenue, growth, and better outcomes. With over 1,600 professionals across the U.S., they operate as One Team, united by a bold mission and a spirit of innovation.

• Supports Medical Policy Directors (MPD) through various aspects of the New Policy processes.
• Performs multi-faceted data and report analytics to provide accurate client or policy information.
• Researches and examines client questions and drafts accurate responses.

Cotiviti provides payment accuracy and analytics-driven healthcare solutions. They have a large team, and cultivate an inclusive and equitable environment for all employees.

• Serve as embedded regulatory thought partner to Clinical and Operations teams, providing real-time guidance.
• Partner with Clinical and Compliance team on policy development, audit response, and remediation strategies.
• Translate complex healthcare regulations into practical guidance and tools.

Headway is building a new mental healthcare system everyone can access by solving the biggest barrier to care: insurance. They have over 75,000 providers across all 50 states run their practice on their software, serving over 1 million patients.

• Oversee prior authorization technicians and administrative PA functions.
• Analyze data and provide staffing, workflow, and system enhancement recommendations.
• Investigate/resolve escalated issues from clients and providers.

Judi Health is an enterprise health technology company providing a suite of solutions for employers and health plans. They have a comprehensive Enterprise Health Platform that consolidates all claim administration-related workflows in one scalable, secure platform.

• Help network development and contracting goals within designated geographies.
• Develop and refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting and other value-based initiatives.
• Address and resolve any concerns raised by providers and effectively communicate those solutions to internal stakeholders.

Clover Health is a Medicare Advantage and Prescription Drug plan changing how healthcare is delivered by combining data with human empathy to keep members healthier. They are passionate and mission-driven individuals, working together to solve the most complicated problem in the world: healthcare.

• Support and help execute ŌURA’s federal government relations strategy.
• Monitor, assess, and communicate relevant legislative, regulatory, and political developments.
• Build and maintain relationships with Members of Congress and other key external stakeholders.

Oura's mission is to empower every person to own their inner potential. They provide millions of people with Oura Ring to understand and improve their health. Oura is a quickly growing company focused on helping people live healthier and happier lives, ensuring that our team members have what they need to do their best work — both in and out of the office.

• Drive solution adoption, educating consultants and employers on the value and integration of solutions.
• Deliver strategic education and serve as the escalation point for technical and clinical questions related to Pareto solutions.
• Partner with Product, Clinical, and vendor partners to improve solution performance at scale through feedback.

ParetoHealth's mission is collective greatness, transforming employee health benefits since 2011. They help small and medium-sized businesses fight rising healthcare costs with financing innovations and a growing ecosystem of partners.

• Serve as the senior leader and strategic business partner for some of Alma’s largest health plan partnerships.
• Develop collaborative working relationships with external health plan executives to identify and capitalize on high-impact growth opportunities.
• Spearhead the development and execution of strategic plans to exceed growth and retention targets for each health plan partnership.

Alma's mission is to simplify access to high-quality, affordable mental health care by making it easy for therapists to accept insurance. They operate in all 50 states, with over 20,000 therapists in their growing network and have raised $220.5M in funding.

• Research and apply federal and state policy, guidance, and regulations using analytical writing to respond to policy help desk inquiries.
• Perform data analysis using tools like Jira, ServiceNow, and Excel to produce reports and draft policy answers for stakeholders.
• Support the development of frameworks, operational plans, and integrated documentation while proactively identifying and resolving gaps.

LMI is a private, nonprofit digital solutions provider and government consulting firm dedicated to accelerating government impact with innovation, speed, and mission-ready technology. Headquartered in Tysons, Virginia, it serves defense, space, healthcare, and energy sectors with a focus on agility, collaboration, and delivering impactful results.

• Own the development and maintenance of clinical and reimbursement policies, ensuring perfect alignment with CMS regulations.
• Design and oversee a robust audit program that monitors adjudication system output against clinical policies, pricing, benefit rules, and provider contract terms.
• Lead the implementation of AI initiatives to automate the monitoring of reimbursement policies and contract validation.

Clover Health aims to improve the health of its members by leveraging technology and data-driven insights to provide personalized, high-quality care. They are a mission-driven team of individuals, who are passionate about solving healthcare's most complicated problems, and strive to put members first.

• Own the development and execution of the company’s pricing strategy for mobile clinical trial services.
• Conduct in-depth market research and competitive analysis to understand pricing trends and client expectations.
• Partner with sales, operations, finance, and senior leadership to ensure pricing aligns with customer needs, internal cost structures, and strategic goals.

Hawthorne Health is a leading community site network and home research visit solution provider, with 20+ sites and more than 2,000 research experienced healthcare professionals across the U.S. They leverage convenient, trusted healthcare locations, identified patient data, and intelligent technology to accelerate patient access, improve retention, and reduce study costs.

• Manage day-to-day relationships with pharmaceutical customers, identify growth opportunities, and provide ongoing communications.
• Provide subject matter expertise related to past industry experience during projects as appropriate.
• Draft/update project deliverables and well-organized presentations to a high level of quality.

Archbow Consulting leverages industry expertise in a consultant capacity to support pharmaceutical and biotech companies. They are committed to hiring and developing exceptional talent and focused on developing inclusive teams that can bring the best solutions.

• Serves as a senior regulatory authority and trusted strategic partner to pharmaceutical and biotech C-suite executives, influencing enterprise-wide regulatory strategies.
• Partners with the SVP & Practice Lead to shape the future direction of the Clinical & Regulatory practice, driving practice growth and translating regulatory landscape evolution into opportunities.
• Proactively supports the practice's P&L, achieving annual revenue targets, leading pursuit strategies for high-value engagements, and setting delivery quality standards across the regulatory team.

Lumanity is dedicated to improving health outcomes by accelerating and optimizing access to life-changing medicines. As a global strategic partner, it brings together strategy, evidence, engagement, and technology to engineer breakthrough value for clients in the healthcare sector.

• Produce policy research, commentaries, and other written products addressing key issues in privatization.
• Research federal, state, and local government finance issues.
• Support team members in working with elected officials and government managers.

Reason Foundation advances a free society by developing, applying, and promoting libertarian principles, including individual liberty, free markets, and the rule of law. The organization produces respected, nonpartisan public policy research on a variety of issues and publishes the critically-acclaimed Reason magazine.

• Lead and develop a high‑performing Account Management team.
• Own the strategy, operating model, governance, and results of the Cell & Gene Therapy Center of Excellence.
• Drive portfolio growth, retention, renewals, contract negotiations, pricing strategy, and margin performance.

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. They are known for delivering insights, products, and services that make quality care more accessible and affordable and foster a culture where employees can grow and make an impact.

• Managing lobbying contractors ensuring their activity is tracked and delivered.
• Supporting compliance across lobbying activity, relevant disclosures and requirements.
• Building dashboards, reporting frameworks and quarterly operating reviews tied to KPIs.

VGW is an interactive entertainment company that develops free-to-play online social games. Values like inclusivity, flexibility, and career growth are encouraged within the company of employees who enjoy a healthy work-life balance.