Drive the department's strategy, program design, and implementation to enhance program value.
Understand competitive landscape, member needs, and healthcare trends; serve as a thought leader.
Lead cross-functional initiatives, manage budgeting, and develop direct reports.
Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. Founded in 2012, it aims to behave like a doctor in the family and supports authentic, diverse perspectives.
Serve as clinical subject matter expert and operational driver for prior authorization.
Build tools, drive process improvements, and mentor peer pharmacists on clinical protocols.
Handle complex escalations, appeals, and cross-functional collaboration to scale clinical operations.
SmithRx is a venture-backed Health-Tech company disrupting the PBM market with cutting-edge technology. Since 2016, we have onboarded hundreds of thousands of members and pride ourselves on a mission-driven, collaborative culture.
Lead product initiatives from discovery through business case creation.
Analyze healthcare data to identify opportunities and develop product strategies.
Collaborate across lines of business to deliver innovative pharmacy solutions.
Express Scripts develops innovative pharmacy solutions to improve customer experiences and drive growth. It offers a fast-paced, collaborative environment with cross-functional teams across healthcare businesses.
Lead quality strategy and AI-enabled monitoring to shift from manual audits to real-time automated controls.
Own software and operational quality by partnering with Engineering and Product on test automation and release validation.
Drive process design and cross-functional accountability to reduce error rates by 50% within the first year.
PHIL is a Series D health-tech company building a platform that connects patients, prescribers, pharmacies, and pharmaceutical manufacturers to get medication quickly and affordably. They are a dedicated team of people from a wide range of backgrounds, united by a focus on the patient experience.
Lead clinical care model execution and scalable systems integration across all markets.
Drive value-based performance metrics including patient engagement, HEDIS/STARs, and total cost of care.
Manage and mentor clinical directors and care teams while partnering with product and operations.
Accompany Health provides primary, behavioral, and social care for patients with complex needs, offering at-home and virtual care with 24/7 support. Their distributed, mission-driven teams collaborate to deliver high-quality, evidence-based care.
Master Specialty Care's P&L mechanics and financial drivers to drive sustainable growth and margin expansion.
Lead cross-functional alignment across Product, Clinical, Marketing, and Operations to set strategic roadmaps and drive execution.
Build AI-native workflows and capacity models to scale clinical operations and improve quality and efficiency.
Spring Health is a global mental health company on a mission to eliminate barriers to mental health through an AI-native platform. It serves over 170 million people worldwide and fosters a culture of innovation, inclusion, and AI fluency.
Lead cross-functional teams for claims adjudication, benefit configuration, and production support.
Drive modernization and strategic roadmap for pharmacy claims and configuration capabilities.
Oversee client benefit plan implementation, regulatory compliance, and operational metrics.
Prime Therapeutics is a pharmacy benefit manager (PBM) focused on reimagining pharmacy solutions to simplify healthcare. The company fosters a purpose-driven, inclusive culture and is an equal opportunity employer.
Own engagement health across the full KitCheck customer base, monitoring portfolio performance and directing interventions for at-risk accounts.
Define and maintain the KitCheck engagement scorecard, publish executive summaries, and provide regular account-level updates to CSMs.
Act as a pharmacy operations SME, enabling CSMs, sales, and customers through playbooks, webinars, and proactive account support.
Bluesight creates healthcare information technology solutions that increase efficiency, safety, and visibility for health systems, hospital pharmacies, and pharmaceutical manufacturers. It is a high-growth company with a start-up vibe and over 3,000 customers using its proven solutions.
Provide clinical expertise and strategic recommendations to clients and internal teams on drug spend, formulary compliance, and clinical programs.
Act as a clinical liaison between Plan Operations and other departments, communicating formulary changes and program updates.
Analyze drug benefit designs, prepare clinical marketing materials, and support go-live activities for new client groups.
SmithRx is a venture-backed health-tech company disrupting the PBM sector with a next-generation drug acquisition platform. It has hundreds of thousands of members and a mission-driven, collaborative culture guided by integrity, courage, and togetherness.
Own and maintain the integrated program plan across multiple major initiatives, tracking workstreams, milestones, owners, and dependencies across a dozen-plus functional teams.
Drive alignment and sequence workflows across Operations, Product, Clinical, Commercial, Finance, Marketing, Legal, and Client Success teams.
Stand up and maintain governance structures, including steering committee cadences, working group charters, escalation paths, and decision logs.
Vida is a virtual, personalized obesity care provider that uses evidence-based treatment to help patients manage obesity and related conditions such as diabetes and hypertension. Vida's team of physicians, dietitians, coaches, and therapists takes a whole-person approach to care, and the company is trusted by Fortune 100 companies, major payers, and large providers.
Manage day-to-day operations and provide strategic direction for the Operations Team.
Oversee personnel actions including hiring, training, performance management, and compensation recommendations.
Collaborate with cross-functional teams and vendors to improve processes and resolve escalated issues.
HealthEquity empowers healthcare consumers by providing health savings accounts and financial solutions. The company values diversity, inclusion, and authenticity, fostering a culture where every person is valued.
Owns the financial infrastructure, controls, and operational oversight for medical, pharmacy, and administrative cost management.
Manages vendor financial functions including TPA and PBM reconciliation, payment accuracy, and contract compliance.
Leads regulatory compliance, reserve reporting, and actuarial analysis while developing the finance team.
Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate and prepare future leaders. It operates Emory Health Plan and employs a large, diverse workforce with a collaborative culture focused on professional growth.
Implement and optimize REMS and specialty pharmacy workflows for COMP360 in the U.S.
Manage vendor relationships, compliance metrics, and cross-functional collaboration.
Support launch readiness, audits, and continuous process improvement.
Compass Pathways is a biotech developing COMP360 psilocybin for treatment-resistant depression and PTSD, with FDA Breakthrough Therapy designation. Headquartered in London with a U.S. office in New Jersey, it focuses on patient-centered mental health innovation.
Lead end-to-end payer enrollment operations for a large enterprise client, standing up teams and workflows from day one.
Manage delivery against SLAs, run performance reviews, and own the client relationship and escalations.
Drive automation and process improvements, own account economics, and scale to a portfolio of enterprise clients.
Medallion builds a provider operations platform that automates licensing, credentialing, payer enrollment, and compliance for healthcare organizations. They are a fast-growing healthcare technology company backed by $130M in funding and recognized as a best place to work, on a mission to transform healthcare at scale.
Develop, test, train, maintain, and support clinical systems used in medication management and pharmacy automation.
Serve as a non-supervisory technical and operational leader within Pharmacy Informatics, coordinating complex cross-functional initiatives.
Ensure technology solutions align with clinical, operational, and strategic needs across the pharmacy enterprise.
The Ohio State University is a top-20 public university and one of America's leading academic health centers. It offers a strong sense of community and resources that support professional growth across many fields.
Define and drive the provider experience strategy to help providers build thriving, sustainable practices within the networks.
Lead provider support operations, improving speed, quality, and effectiveness while expanding self-service and AI-enabled support.
Build scalable programs that strengthen provider engagement, retention, and performance across the organization.
Spring Health is a global mental health company on a mission to eliminate every barrier to mental health. The AI-native platform reaches more than 170 million people worldwide through leading employers, health plans, and partners, and the culture values human judgment and AI fluency.
Lead operational testing and experiments for Care & Case Management and navigation teams, including AI calling and intake pilots.
Manage cross-functional projects, own daily and weekly business readouts, and drive Population Health margin initiatives.
Conduct deep-dive operational assessments, leverage AI productivity tools, and partner with product teams to improve outcomes.
Included Health is a healthcare company delivering integrated virtual care and navigation, with a mission to raise the standard of healthcare for everyone. It fosters a remote-first culture and is an equal opportunity employer.
Architect end-to-end TPA solutions across eligibility, claims, billing, and benefit administration.
Own PBM solution design, manage vendor partnerships, and negotiate data standards and SLAs.
Track financial performance, pricing, rebates, and operational health to drive client wins.
Personify Health created the first and only personalized health platform bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs and improve health outcomes.
Own the operating model improving AI-agent and human support performance, including building and governing agent operating procedures (AOPs).
Lead teams executing AOP governance, QA cadence, and knowledge management, partnering with Product and Quality Assurance.
Chair cross-functional triage assigning surfaced gaps to owners and due dates, and report on deflection and resolution quality.
Spring Health is a global mental health company on a mission to eliminate every barrier to mental health, using an AI-native platform that delivers personalized support across coaching, therapy, medication management, and specialty care. The company reaches more than 170 million people worldwide through employers, health plans, and partners, and fosters a culture where technology expands the reach, quality, and humanity of care.
Lead planning, execution, and integrated governance for Future of Medicine initiatives across Clinical Conduct, Quality, Technology, and Operations.
Translate clinical, operational, quality, and program needs into scalable workflows, requirements, SOPs, and training.
Drive readiness, change planning, and sustained adoption of new program requirements and technology capabilities.
Care Access brings world-class clinical research and health services to communities facing barriers to care through hundreds of research locations, mobile clinics, and global clinicians. The company values an inclusive culture where diverse backgrounds are welcomed and people are at the heart of medical progress.