Define and execute digital member experience strategy and multi-year roadmap, aligning with business goals and client commitments.
Own member-facing technology platforms (app, portal, CRM, IVR, chat) and drive adoption, self-service, and satisfaction.
Collaborate with cross-functional teams and lead complex initiatives to improve member engagement and clinical outcomes.
AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. The company is committed to making pharmacy benefits easy to understand and accessible, with a culture focused on doing what’s right and fostering team growth.
Actively assess health plan core administration and operations to identify root-cause drivers of cost, quality, and compliance gaps.
Translate findings into a future-state roadmap and business blueprint that positions BPaaS as a path to improved efficiency and compliance.
Quantify the opportunity with financial models (ROI, IRR, cost-benefit) and build the business case for operations leadership.
HealthEdge provides a BPaaS operating model for health plans to improve efficiency, compliance, and operational outcomes. The company operates remotely and values transformation expertise and collaborative advisory engagements.
Partner with cross-functional teams to design market solutions and define scope for new markets.
Write integration requirements for data exchange between Nomi and claim lifecycle partners.
Own network configuration and pricing, from rate sheet to correctly priced claim.
Nomi Health rebuilds the healthcare system to eliminate waste, focusing on clear pricing, faster payments, and data-driven decisions. They are a team of over 300 employees who challenge the status quo and build better solutions.
Lead and develop a team of Client Executives managing strategic accounts, including C-suite relationships, contract economics, and renewal outcomes.
Build proactive consultant and broker relations, and own retention, renewal, and revenue performance for a book of business.
Coordinate cross-functionally to resolve escalations, develop processes, and contribute to organizational design.
AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. They are committed to making pharmacy benefits easy to understand and always in the best interest of employers and the lives they impact.
Serve as the primary claims resource for commercial clients, managing investigations, documentation, and communication throughout the claims process.
Monitor open claims, review reserves and settlement strategies, and support workers' compensation programs.
Collaborate with producers, account executives, risk advisors, and carriers to identify cost reduction and risk management opportunities.
Leavitt Risk Advisory is a commercial and personal lines insurance brokerage that manages risk for individuals and businesses. As part of the Leavitt Group, one of the nation's largest privately held insurance brokerages, they combine local agency culture with national resources and support.
Lead the strategy and execution of provider-facing risk adjustment initiatives.
Partner with teams like Network, Data Science, and external providers for cross-functional program delivery.
Analyze provider performance to identify opportunities and develop improvement plans.
Oscar is a health insurance company built around a full-stack technology platform focused on serving its members. Founded in 2012, Oscar is a sizable organization that fosters a culture of authenticity and belonging.
Manages claim strategies and resolutions while advocating for optimal client outcomes.
Communicates claim information to internal and external clients and maintains strong relationships.
Develops expertise in multiple coverage lines and participates in presentations and new business pitches.
IMA Financial Group is an independent insurance brokerage providing risk management, employee benefits, and wealth management solutions. With a focus on associate ownership and team-based culture, the company has been recognized as a best place to work by multiple publications and operates nationally.
Own claims end to end for commercial accounts, from intake to resolution.
Lead kickoff calls, monthly claim reviews, and be the client's first call when incidents occur.
Build SOPs and reporting workflows while pushing carriers and TPAs for movement.
WithCoverage replaces traditional insurance brokerage with AI-supercharged risk management for modern economy clients like GoPuff and Bombas. The company has raised over $43M from Sequoia, 8VC, and Khosla Ventures and offers a collaborative, transparent culture.
Lead a team of account managers to drive retention and growth across pharmacy relationships.
Implement proactive engagement models with business reviews and strategic check-ins.
Align RxSense's solutions with partner objectives and pursue organic growth opportunities.
RxSense is a healthcare technology company providing platforms to improve the management and access of cost-effective pharmacy benefits. They serve enterprise and partnership clients with SaaS solutions, and foster a diverse, collaborative workforce.
Lead a multidisciplinary team integrating QA oversight, technical system management, and medication policy execution.
Drive clinical strategy, prior authorization platform management, and data-driven process improvements.
Ensure safety, evidence-based compliance, and operational excellence across the PA ecosystem.
SmithRx is a venture-backed Health-Tech company disrupting the Pharmacy Benefit Management (PBM) sector with a next-generation drug acquisition platform. With hundreds of thousands of members onboarded since 2016, the company is guided by a mission-driven and collaborative culture that inspires employees to transform the U.S. healthcare system.
Lead credentialing and payer enrollment functions, setting strategic objectives and performance standards.
Manage vendor relationships and resolve enrollment-related revenue cycle issues.
Develop scalable processes, dashboards, and compliance initiatives to reduce backlogs and improve efficiency.
Jobgether is a platform that uses AI to match job seekers with opportunities. They partner with companies to manage applications and next steps, aiming to streamline the hiring process.
Lead end-to-end project lifecycle for strategic initiatives like Engage rollout and new launch preparation.
Drive change enablement by addressing operational challenges and directing team efforts to meet aggressive deadlines.
Manage cross-functional relationships and serve as liaison to proactively push projects forward.
Lyra Health is a leading provider of evidence-based mental health care, serving over 20 million people globally. The company has delivered over 15 million sessions of care and published 35+ peer-reviewed studies, fostering a culture of clinical excellence and innovation.
Lead strategic growth and operational management of pharmacy benefit and managed care relationships nationwide.
Oversee contract evaluation, negotiation, implementation, and renewal with major healthcare payers.
Analyze reimbursement trends and contract performance to support revenue optimization and business growth.
This company operates in the specialty pharmacy sector, supporting patients with chronic and rare illnesses. It is a mission-driven, rapidly growing environment focused on improving access, care, and outcomes for patients with complex healthcare needs.
Manage formularies, coverage determinations, and benefit design for PBM services.
Resolve clinical inquiries from members, clients, providers, and pharmacies.
Support P&T Committees with drug monographs, summaries, and medication policies.
OHSU is Oregon's only public academic health center with hospitals, clinics, and research schools. It is Portland's largest employer and a national research hub, welcoming diverse backgrounds.
Sets strategic direction for assigned market(s) and manages key external stakeholder relationships.
Oversees ACO operations, financial accountability, and professional development of direct reports.
Collaborates with central growth team to establish partnerships and achieve value-based care targets.
Aledade PBC empowers independent primary care practices to thrive in value-based care. Founded in 2014, it has become the largest network of independent primary care in the US with a collaborative, inclusive, and remote-first culture.
Adjust the most complex and high exposure Allied Health claims requiring advanced technical expertise and negotiation.
Investigate coverage, draft reservation of rights, and manage litigation with defense counsel and experts.
Collaborate with internal and external stakeholders to drive optimal resolution strategies.
Integrated Specialty Coverages is a technology and data-driven commercial MGA and insurance wholesaler. Backed by Onex Partners, it combines insurance and technology to drive innovation and growth.
Lead end-to-end strategy and execution for go-to-market efforts of Risk Stratification programs and products.
Own strategic partnerships with payer partners, practice leaders, and vendors to advance insight delivery.
Direct and support cross-functional teams on related initiatives, including incentive programs, monitoring, and value estimation.
Aledade PBC is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. Founded in 2014, it is the largest network of independent primary care in the country, fostering a collaborative, inclusive, and remote-first culture.
Serve as backup systems administrator for WHL applications, ensuring stability, availability, and performance.
Analyze application performance and workflows to identify improvements and manage technical projects.
Coordinate with vendors, stakeholders, and teams to deliver technology initiatives.
Tivity Health, Inc. is a leading provider of healthy life-changing solutions, including SilverSneakers, ForeverFit, and WholeHealth Living. We help adults improve their health and support them on life's journey by providing access to in-person and virtual physical activity, social and mental enrichment programs, as well as a full suite of physical medicine and integrative health services.
Define and execute a holistic provider performance vision, establishing standardized frameworks across clinical service lines.
Lead, mentor, and build a high-performing operations team, setting high-impact priorities.
Partner with Data Analytics to build a unified data vision and establish centralized systems to measure provider performance.
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally. The company has delivered more than 15 million sessions of mental health care and published more than 35 peer-reviewed studies.
Manage commercial general liability claims from investigation to resolution, including coverage analysis, damages evaluation, and negotiation.
Handle bodily injury, auto material damage, and total loss claims, including vehicle appraisal, subrogation, and salvage procedures.
Ensure compliance with state regulations, maintain accurate reserves, and provide excellent customer service to insureds, agents, and internal stakeholders.
Berkley Southeast Insurance Group is a member company of W.R. Berkley Corporation, a Fortune 500 company, offering local underwriting, risk services, claim, marketing, and audit services for agents and policyholders in the southeastern US. As a part of a large, well-rated organization, the company emphasizes a broad underwriting approach for best-in-class businesses.