Directly supports the performance of the Proclaim Plan Automation and QA teams.
Ensures consistency in process and workflow as well as maintaining standard policies and procedures aimed at improving overall operational performance.
Serves as the business partner contact for Sales, key initiative enterprise project teams, baseline project teams, Claim, Product Service Partners, Product Benefit Advisory Board (PBAB), Exception Review Committee (ERC), and Systems.
The Cigna Group is dedicated to improving the health and vitality of those they serve. Through their divisions Cigna Healthcare and Evernorth Health Services, they are committed to enhancing the lives of their clients, customers and patients.
Be the primary face to the client during the implementation process
Conduct impact analysis with client to determine the appropriate requirements for a smooth and successful implementation
Create and maintain a detailed project plan and open items log for project monitoring purposes
SmithRx is a rapidly growing Health-Tech company aiming to disrupt the Pharmacy Benefit Management (PBM) sector. They have a mission-driven and collaborative culture that inspires their employees to do their best work and are guided by their company values: Integrity, Courage, and Together.
Manage all inbound phone, text, and email support to ensure clients feel supported.
Build and maintain a QA function to review response quality and coach the team.
Identify inefficiencies in workflows and tooling, and implement solutions.
Prosper Health aims to improve the lives of autistic and neurodivergent adults by delivering specialized, insurance-covered mental health services. They have thousands of active clients and 400+ clinicians, and their team is high-ownership and mission-driven.
Lead client onboarding and technical implementation, from scope definition to launch.
Drive consistency within pharmacy product workflows across clients.
Manage system configuration, evaluate technical integrations, and optimize reliability.
Strive Pharmacy personalizes medicine through compounding to provide individualized solutions with fewer side effects. With a mission to disrupt healthcare, they value the 'human element' and foster a community through various celebrations, promoting both personal and professional employee development.
Directly lead and manage a Patient Support team to ensure medication adherence or provide timely prior authorization and financial assistance.
Proactively manage support in assigned hospitals/clinics to ensure patients receive medications on time and that all service level goals are met.
Manage all aspects of ADP, Paid Time Off (PTO), and Time Reports for team members while completing audits of the team in supported systems.
Shields Health Solutions provides specialty pharmacy management services, helping patients get medications on time. They are a fast-growing company that values motivated self-starters focused on high quality.
Analyze and support non-clinical workflows across CM, CDM, and UM programs.
Translate operational and clinical requirements into process maps, SOPs, and job aids.
Support workflow automation and system optimization initiatives.
Personify Health created a personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes.
Manage insurance product projects to build and launch new project features.
Create, document, and improve insurance product processes to support Gravie products.
Configure and own documentation creation and management process for our plan portfolio.
Gravie aims to create health benefits for small and midsize businesses and their employees. It is composed of a diverse group of unique people that encourages you to be your authentic self.
Improve end-to-end patient support workflows, from first contact through resolution and follow-up.
Analyze support and call center metrics to uncover trends, pain points, and operational gaps — and turn insights into action.
Champion and evolve our QA program — ensuring we’re not just scoring interactions, but using them to elevate performance and consistency.
Midi Health's mission is to redesign care for women in midlife. They are growing fast and seeking purpose-driven people to help them build a best-in-class team.
Support implementation and client management teams with all day-to-day client requirements
Responsible for timely and accurate management and execution of all client benefit requests
Analyze incoming client requests and work with internal and external teams to complete required plan documentation
Judi Health is an enterprise health technology company providing solutions for employers and health plans, including pharmacy benefit management and health benefit management solutions. They focus on rebuilding trust in healthcare. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table.
Design, implement, and optimize operational workflows for the Workers' Compensation division.
Support and manage operational teams, including training and performance management.
Develop and track KPIs to measure operational excellence and program performance.
Scan.com is a digital health company making diagnostics accessible, fast, and transparent. They have raised over $70m in VC funding, reached profitability, and have a growth trajectory of over 100% YoY, and their B2C marketplace simplifies booking a scan.
Lead, coach, and mentor a team of Customer Operations Specialists to meet and exceed performance expectations.
Monitor daily workflows and queues to ensure timely, accurate resolution of provider and client inquiries.
Track and analyze team performance against key metrics, including OKRs and productivity KPIs.
Grow Therapy is a technology-powered marketplace that empowers therapists, augments insurance payors, and serves patients in need of mental healthcare. They have raised more than $178mm of funding and have empowered more than ten thousand therapists and hundreds of thousands of clients across the country.
Oversee daily claim workflows ensuring accuracy, timeliness and adherence to compliance requirements within Required SLAs.
Own team performance across CSAT, Quality, Productivity, Aging, and SLA, translating results into clear action plans.
Coach and develop team members through 1:1s, performance management and targeted development plans.
Extend is revolutionizing the post-purchase experience for retailers and their customers by providing merchants with AI-driven solutions. Extend works with more than 1,000 leading merchant partners across industries and our headquarters is in downtown San Francisco.
Be accountable for Partner satisfaction and relationship
Build trusting relationships with Partners’ operational leadership
Maintain a comprehensive understanding of business and technical challenges faced by customers
SmithRx is a rapidly growing, venture-backed Health-Tech company. Their mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector. They pride themselves for their mission-driven and collaborative culture that inspires their employees to do their best work.
Work in a partially remote environment, collaborating with team members virtually each day.
Serve as a Subject Matter Expert (SME) on quality improvement measures, customer needs, and payer‑specific quality initiatives across commercial and government programs.
Conduct proactive patient outreach to identify and close quality gaps—educating patients, scheduling screenings, supporting treatment plan adherence, and improving outcomes.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Instrumental in designing, implementing, and administering comprehensive global benefits and leave programs.
Ensuring compliance, promoting employee well-being, and enhancing reputation as an employer of choice.
Delivering an exceptional Villager experience, directly contributing to Anchorage’s strategic goals and a culture of excellence.
Anchorage Digital is building the world’s most advanced digital asset platform for institutions to participate in crypto through custody, staking, trading, governance, settlement, and security infrastructure. They are a diverse team of more than 600 members.
Lead registration and configuration of end users and partners on DrFirst products.
Enhance customer experience and satisfaction through client surveys.
Independently manage multiple priorities, including customer setups and registrations.
DrFirst empowers providers and patients to achieve better health through intelligent medication management. They improve healthcare workflows and help patients start and stay on therapy with end-to-end solutions, serving over 420,000 prescribers, 71,000 pharmacies, and 2,000 hospitals.
Provide direct supervision, coaching, and performance oversight to clinical managers.
Serve as a primary operational liaison between clinical teams and health plan care management teams.
Oversee onboarding and training for care teams and clinical managers.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers. They cultivate a dynamic and inclusive team environment.
Leading the Personal Support and Nursing Management team.
Providing professional knowledge and support to the team.
Supporting daily operations of client services, case management, and human resources.
CarePartners is one of Ontario’s largest accredited home health care providers, providing nursing, personal support, therapy and rehabilitation support services for patients of all ages. They care for approximately 72,000 patients each year in homes, schools, clinics, workplaces and retirement homes, through their 24 locations and 24 nursing clinics.
Respond to inbound inquiries from providers, medical office staff, and payers by phone, email, and internal messaging
Support providers with real-time order status updates, prescription processing steps, and plan-specific requirements
Triage escalations and resolve urgent or complex order-level issues efficiently
PHIL is a Series D health-tech startup building a platform that interfaces between doctors, pharmacies, and patients to streamline the process of patients receiving prescriptions. The team at PHIL is a group of like-minded individuals from varying backgrounds, passionate about creating a new and innovative healthcare platform that is focused on patient experience and overall human wellbeing.
Partner with Operations leaders and cross functional stakeholders to drive operational excellence through structured process analysis, optimization, and transformation.
Evaluate end to end workflows, identify performance gaps, and deliver data driven recommendations that enhance efficiency, scalability, risk control, and customer outcomes.
Ensure measurable value by improving service quality, reducing variability and rework, enabling automation, and strengthening governance and operational discipline.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. As a FTSE 100 Index company listed on the London Stock Exchange, they have a team of 22,500 people across 32 countries.