Own end-to-end program management for supplemental benefit implementations.
Lead vendor management across multiple benefit categories, serving as the primary point of accountability for vendor performance and delivery.
Drive large, complex implementations by coordinating across Plan Product, Operations, Call Center Operations, Compliance, and external partners.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep members healthier. They've created custom software and analytics to empower clinical staff to intervene and provide personalized care. They are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Lead the development, optimization, and performance of Clover’s dental provider network.
Build Clover’s dental network strategy from the ground up across markets.
Build, scale, and lead a high-impact dental network team spanning contracting, analytics, and provider relationship management.
Clover Health is committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. The company prioritizes preventive care while leveraging data and technology; they are passionate and mission-driven individuals with diverse areas of expertise.
Establish and monitor performance metrics to measure the reliability and latency of payer data feeds.
Serve as the primary point of escalation for high-priority payer data issues, coordinating with various teams.
Oversee the documentation and submission processes for clinical data extracts to ensure audit readiness.
Aledade empowers independent primary care practices to deliver better patient care and thrive in value-based care. As the largest network of independent primary care in the country, they focus on creating value-based contracts, strengthening care continuity, and aligning incentives to ensure physicians are paid for keeping patients healthy.
Serves as a primary interface between clinical services and other departments to ensure multi- and inter-disciplinary vendor project coordination.
Assists clinical department directors and others in the interpretation and use of data for decision-making.
Improves and innovates the use of technology within clinical practice and workflows.
Capital Blue Cross promises to go the extra mile for their team and community. They are an independent licensee of the Blue Cross Blue Shield Association that values professional and personal growth by investing heavily in training and continuing education.
Oversee day‑to‑day clinical operations for UM, CM, and DM teams.
Ensure operational workflows meet productivity, quality, and turnaround time expectations.
Partner with the VP of Care Management on operational priorities and process improvements.
Personify Health created the first and only personalized health platform bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. It serves employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes.
Own critical components of the provider lifecycle, driving readiness to see members on the platform and scalable growth.
Identify bottlenecks and implement improvements that accelerate time-to-platform and strengthen provider engagement.
Improve systems and workflows through automation and process design, reducing manual work and operational risk.
Maven is the world's largest virtual clinic for women and families, aiming to make healthcare accessible for everyone. With over 2,000 employers and health plans as clients, Maven provides comprehensive support spanning fertility, maternity, parenting, and menopause. He fosters an award-winning culture.
Partner with cross functional leaders to ensure internal processes and care delivery are in accordance with health plan needs across commercial and Medicaid lines of business
Translate health plan contracts, provider manuals, and regulatory requirements into scalable operational workflows
Serve as the internal subject-matter expert on credentialing and payor operational requirements
Equip is a virtual, evidence-based eating disorder treatment program. They aim to provide accessible and effective treatment. Founded in 2019, Equip has been a fully virtual company and has a highly-engaged, passionate, and diverse culture.
Oversee & manage program KPIs for the frontline clinical staff working across the Virtual Primary Care (VPC) and Virtual Care Support (VCS) teams
Create and implement data-driven staffing and resource plans, partnering with relevant teams (Forecasting, Clinical Leadership, Recruitment, Licensing)
Drive a POV on the technical enablement and tooling optimization opportunities to drive operational efficiencies for scale and clinical outcomes
Included Health delivers integrated virtual care and navigation to raise the standard of healthcare for everyone. The company breaks down barriers to provide high-quality care for every person in every community, offering care guidance, advocacy, and access to personalized virtual and in-person care.
Lead the development and execution of Clover’s provider network strategy in New Jersey.
Establish and execute on an annual contracting roadmap aligned with affordability, access, and quality goals.
Lead a team to deliver high-quality and data-driven contracting operations.
Clover Health reinvents health insurance by combining data and human empathy to keep members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care.
Identify operational efficiencies for Apogee in partnership with key CROs and vendors and implement solutions to support delivery of Clinical Trial Operations team.
Partner with key stakeholders including Clinical Trial Operations, Vendor and Strategic Management to ensure vendor performance aligned with Apogee expectation.
Proactively identify and maintain standards to ensure consistency across all programs and studies for operationalizing global clinical trials working with assigned CRO’s.
Apogee Therapeutics is a clinical-stage biotechnology company advancing novel biologics with potential for differentiated efficacy and dosing in the largest I&I markets. They have a fast-paced company culture, founded on their C.O.R.E. values: Caring, Original, Resilient and Egoless and a commitment to refusing to stop at “good enough”.
Responsible for establishing an infrastructure to support negotiations, implementation and oversight with all contracted vendors.
Develop metrics reporting from all vendors and have strong analytical skills to evaluate effectiveness of programs.
Serve as liaison between vendors and claims staff; audit, measure, report and evaluate all vendor’s performance.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products. They have over 2000 employees and are known for their employee-first focus and commitment to diversity, equity, and inclusion.
Drive and elevate provider quality initiatives at Rula through data-driven decision making.
Lead scalable quality initiatives across the provider network by identifying gaps and driving programs.
Translate complex data into clear actions for initiatives like provider quality reviews and AI-powered documentation.
Rula is committed to destigmatizing and embracing mental health as integral to overall well-being. They provide quality, evidence-based care and aim to empower individuals in their mental health journey, operating as a remote-first company.
Support operational aspects necessary for a health benefits offering including onboarding, offboarding, reporting, contribution adjustments and more.
Responsible for ensuring data provided by our customers is entered correctly and on time in our system to ensure we withhold and report accurately.
Provide reports to customers and third party benefits providers
Wrapbook is a smart, intuitive platform that makes production payroll and accounting easier, faster, and more secure. They are a growing team of 250+ people across the USA and Canada, including entertainment and technology experts from SAG-AFTRA, DGA, IATSE, Teamsters, Amazon, Microsoft, Facebook, and more.
Own end-to-end contract lifecycle for extensive contract portfolio.
Partner directly with practices to ensure successful contract onboarding and ongoing compliance.
Act as the SME of the Explorer market with all relevant groups such as Payer Networks, SPP, Withdrawal, Legal, and Growth teams.
Aledade, a public benefit corporation, empowers independent primary care. Founded in 2014, they've become the largest network of independent primary care in the country, helping practices deliver better care and thrive in value-based care with a collaborative, inclusive, and remote-first culture.
Oura's mission is to empower every person to own their inner potential. They provide award-winning products that help their global community gain a deeper knowledge of their readiness, activity, and sleep quality. As a quickly growing company focused on helping people live healthier and happier lives, they ensure that their team members have what they need to do their best work — both in and out of the office.
Partner with RCM leadership to monitor performance trends and identify revenue cycle opportunities.
Support payer contracting activities, including onboarding clinical network agreements.
Act as program manager for strategic payer partnership initiatives and drive implementation.
Headspace provides access to lifelong mental health support. They combine content, clinical care, and technology to help millions of members around the world get support. Their culture is collaborative, inclusive, and grounded in their values.
Oversees the management of contractual documents that establish business relationships with vendors, customers and/or partners.
Advises management of contractual rights and obligations and provides interpretation of terms and conditions.
Manages team responsible for data entry, configuration within systems and maintenance of all changes in terms and conditions of payor contracts.
Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value.
Own the end-to-end performance of the claims operation.
Drive claims quality, speed, and scalability through inventory management.
Develop the claims department's client experience strategy.
Centivo is an innovative health plan for self-funded employers. They are on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills and work with employers ranging in size from 51 employees to Fortune 500 companies.
Oversee day-to-day operations across multiple orthodontic practices.
Drive performance in production, collections, insurance aging, and overall year-over-year growth.
Mentor and support Office Managers and Assistant Managers daily.
MB2 Dental is a Dental Partnership Organization (DPO) founded in 2007. They support affiliated Orthodontic practices and offer a competitive compensation package.
Zócalo Health is a tech-enabled primary care organization that focuses on serving underserved populations by partnering with health plans, providers, and community organizations to deliver culturally competent care. Founded in 2021, they combine local teams with virtual care and technology to deliver whole-person care and are rapidly scaling across states and populations.