Source Job

• Counsel patients via telephonic outreach on medication adherence and make evidence-based recommendations.
• Perform focused clinical chart reviews to inform patient interventions and document commitments.
• Escalate complex cases to prescribers and meet performance goals such as STARs and HEDIS.

Aledade is a public benefit corporation dedicated to empowering independent primary care practices. Founded in 2014, it has become the largest network of independent primary care in the country, fostering a collaborative, inclusive, remote-first culture.

• Build and maintain customer relationships, leading account teams to deliver results that demonstrate value.
• Manage financial aspects of accounts including revenue goals, cost of care, and contract compliance.
• Identify opportunities for additional services and develop strategic business plans for long-term client retention.

Prime Therapeutics is a pharmacy benefit manager (PBM) focused on connecting care and reimagining pharmacy solutions. The company values a purpose-driven culture and aims to simplify healthcare.

• Complete a 25-minute asynchronous survey on your own schedule.
• Detail your organization's criteria for selecting and evaluating pharmacy benefit partners.
• Rank the strategic priorities that drive your contracting decisions.

Terac is building the world's largest pool of vetted human experts for AI. The company's size and culture are not specified, but it focuses on recruiting and paying study participants across industries.

• Operate within pharmacist-led clinical programs focused on chronic disease, quality improvement, and medication optimization.
• Conduct Medication Reconciliation, Medication Therapy Management, and Comprehensive Medication Reviews.
• Collaborate with interdisciplinary teams, including physicians and health coaches, to develop patient-specific action plans.

Vytalize Health is a value-based healthcare organization that partners with providers to improve patient outcomes and reduce costs. They are a rapidly growing company with a culture focused on collaboration and innovation.

• Develop and execute strategies to drive revenue growth and expand market presence with payers.
• Lead and mentor a small payer sales team to optimize performance and achieve revenue targets.
• Monitor industry trends and regulatory changes to identify opportunities and mitigate risks.

Cohere Health provides a clinical intelligence platform using AI to connect health plans and providers, improving care speed, cost, and quality. The company has been named to the Inc. 5000 list and is backed by leading investors.

• Deliver safe, evidence-based GLP-1 prescribing and take full accountability for daily clinical quality, safety, and governance of your team.
• Lead clinicians in a fast-moving telehealth environment, set clear standards on prescribing quality, audit, and escalation.
• Translate new evidence and regulatory guidance into practical clinical protocols and provide feedback to product teams.

AIOS is building the world's first full-stack AI doctor, serving 150k patients per month via Bolt Pharmacy in the UK. The company is at $350M ARR, growing rapidly from $10M a year ago, and is profitable with a young, founder-led culture.

• Perform clinical review and evaluation of pharmacy prior authorization requests to determine medical necessity and appropriateness.
• Coordinate appeals and provide clinical consultation to providers, members, and internal stakeholders.
• Support utilization management initiatives, develop clinical criteria, and drive quality improvement across clinical programs.

FairosRx is an innovative company striving to reduce the cost of healthcare. They have a tight-knit culture based on an outward mindset and are growing quickly.

• Lead strategic and operational clinical pharmacy services for specialty clinics, overseeing a team of clinical pharmacists and driving high-quality patient care.
• Serve as the primary liaison between pharmacy services and clinic leadership, fostering interdisciplinary partnerships and program expansion.
• Manage staff recruitment, onboarding, performance, and clinical quality while supporting pharmacist development and operational excellence.

Shields Health Solutions is a specialty pharmacy company that partners with health systems to deliver comprehensive medication management and improve patient outcomes. The company emphasizes innovation, collaboration, and clinical excellence, supporting a team of pharmacists dedicated to high-quality care.

• Review and evaluate medication orders for accuracy, appropriateness, and safety.
• Provide medication counseling to patients, addressing questions and concerns.
• Collaborate with healthcare providers to develop and monitor medication therapy plans.

Shields Health Solutions provides pharmaceutical care services, specializing in therapy management programs for patients with conditions like diabetes and weight management. The company focuses on remote collaboration with healthcare professionals to ensure safe and effective medication therapies.

• Drive strategic partnerships with national payers to accelerate growth and expand access to value-based cancer care.
• Lead cross-functional collaboration with Clinical Operations, Finance, and Product to manage payer relationships from opportunity analysis through contracting.
• Own the full sales cycle including RFP processes, contract negotiations, and operational handoffs to ensure long-term success.

Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. Backed by several venture capital firms and led by CEO Dr. Justin Bekelman, the company is a pioneering startup in cancer care.

• Act as a trusted liaison between patients and healthcare providers, providing expert guidance on pharmacy benefits.
• Own patient cases end-to-end, resolving coverage, prior authorization, and appeals issues.
• Collaborate with stakeholders to ensure members navigate the healthcare system with confidence.

AffirmedRx is a pharmacy benefit management company on a mission to improve healthcare outcomes by bringing clarity, integrity, and trust to the industry. They are a mission-driven organization committed to patient-centered care and ethical practices.

• Lead the design, development, and lifecycle management of analytical and automation products for payer health plans.
• Translate market needs and customer insights into product capabilities that improve health plan performance and cost management.
• Partner cross-functionally with Engineering, Data Science, and Sales to drive product strategy and commercial success.

MedeAnalytics is an enterprise healthcare performance company that delivers AI-driven cloud solutions to payers and providers. With over 30 years of industry experience, the company fosters a culture of innovation and impact.

• Lead managers and supervisors responsible for member enrollment and billing operations.
• Drive achievement of client SLAs, quality metrics, productivity, and financial targets.
• Partner with clients and internal stakeholders to identify operational improvements and foster a culture of accountability.

Sutherland leverages artificial intelligence, automation, and cloud engineering to drive digital transformation for iconic brands. With over 200 patents and a focus on human-machine collaboration, the company delivers measurable results through a seamless 'as a service' model.

• Support assigned payer client implementations through prescriptive workflow execution and system build input.
• Deliver end-user and super-user education using adult learning principles.
• Monitor standard KPIs and review dashboards to identify adoption or utilization concerns.

We are an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Since 2013, we have grown to be recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, and we are one of the fastest-growing privately-held companies in the country.

• Lead the strategy to secure national payor agreements, moving from state-by-state enrollment to national in-network contracts with major commercial payors.
• Manage a Credentialing Specialist, setting SLAs and KPIs for credentialing turnaround time, while overseeing payor enrollment and claim denial resolution.
• Partner with Clinical Ops and Revenue Cycle to align provider onboarding with credentialing lead times and national agreement rollouts.

Happy Health is revolutionizing sleep medicine delivery through a comprehensive telehealth platform that eliminates traditional barriers to sleep care. The company is a fast-moving, low-ego team that values ownership and problem-solving over process, operating remotely with a physical office in Austin, TX.

• Develop and execute the Market Access Payer strategic plan and vision for national and regional markets to support product launch.
• Lead and inspire a team of national account directors to achieve Market Access objectives and establish payer formulary coverage.
• Collaborate with commercial leadership and executive management to refine payer access strategy and provide input on pricing, contracting, and customer partnerships.

Olema Oncology is a clinical-stage biopharmaceutical company committed to transforming the standard of care for patients with breast cancer. They are a growing, nimble team of self-starters dedicated to developing better therapies and building a positive company culture.

• Deliver safe, evidence-based GLP-1 prescribing for every patient, taking full ownership of clinical quality.
• Run detailed consultations that capture everything first time, tracking treatment response and escalating red flags.
• Maintain accurate clinical records, contribute to audits, and collaborate with support, operations, and tech teams.

AIOS is building the world's first full-stack AI doctor, serving 150k patients monthly via Bolt Pharmacy. The company is at $400M ARR, profitable, and growing rapidly with a young, founder-led culture.

• Evaluate AI-generated responses to pharmaceutical scenarios for accuracy and safety.
• Compare multiple model answers and select the best based on current pharmacy standards.
• Write improved exemplars and structured feedback to help AI models learn.

Prolific is building the world's largest pool of quality human data, connecting AI developers and researchers with paid study participants. With over 35,000 AI developers and organizations using the platform, Prolific offers flexible, remote work opportunities for domain experts to train and evaluate AI models.

• Lead the execution of market access and reimbursement strategies for biologics and rare disease therapies.
• Develop and maintain executive-level relationships with national payer stakeholders to negotiate high-impact agreements.
• Provide strategic insights on payer trends and competitive dynamics to shape commercial strategy.

Dr. Reddy's is a global pharmaceutical company dedicated to making medicines affordable and discovering innovative treatments to help people lead longer, healthier lives. The company fosters a culture of empathy, dynamism, and inclusion, valuing diverse perspectives and teamwork.

• Participate in a remote video interview to discuss your company's benefits strategy.
• Review hypothetical plan structures and provide feedback on their appeal.
• Share insights on how your organization evaluates and renews corporate health plans.

Terac is building the world's largest pool of vetted human experts for AI. They are a growing company that recruits and pays study participants across industries, languages, and skill sets.