Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.
Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.
Interview, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.
Humana Inc. is committed to putting health first for its teammates, customers, and company. Through Humana insurance services and CenterWell healthcare services, they aim to make it easier for the millions of people they serve to achieve their best health.
Offer field-based reimbursement education and patient access expertise to leading HAE centers and the healthcare provider community.
Act as the primary contact for all reimbursement and access-related inquiries.
Collaborate with Regional Business Managers, HCPs, specialty pharmacies, payers, patients, and our HUB vendor partner.
KalVista is a global pharmaceutical company dedicated to delivering life-changing oral therapies for individuals affected by rare diseases with significant unmet needs. They are working closely with the global HAE community to improve treatment and care for this disease around the world.
Drive sales performance within the assigned region.
Provide leadership and strategic direction to Specialty Sales Representatives.
Coach and mentor the team and collaborate with cross-functional teams and business partners.
ARS Pharmaceuticals is committed to bringing novel products forward to improve patient outcomes and lives. They promote a culture of inclusivity, integrity, and creativity while pursuing solutions for families affected by serious allergic reactions.
Lead and manage daily prior authorization operations across all locations.
Oversee workload distribution and productivity; Track and mitigate revenue at risk.
Hire, train, coach, and develop authorization supervisors and authorization staff.
Metro Vein Centers specializes in state-of-the-art vein treatments. With over 60 clinics across 7 states, they deliver compassionate, results-driven care in a modern, patient-first environment.
Oversees daily operations of the Care Management unit and ensures process implementation.
Facilitates staff development, provides regular performance feedback, and identifies areas of improvement.
Evaluates performance metrics, supports staff in care planning, and promotes interdisciplinary collaboration.
Capital Blue Cross promises to go the extra mile for our team and our community. They offer a caring team of supportive colleagues and invest heavily in training and continuing education. Employees consistently vote them one of the “Best Places to Work in PA.”
Develops value proposition resources and key messages aligned with Brand strategy.
Supports Payer Accounts team in strategic and tactical business planning for payers and hospitals.
Iovance is dedicated to developing and delivering novel cancer immunotherapies. They are an equal-opportunity employer committed to cultivating a diverse and inclusive work environment.
Collaborate with field reimbursement managers to identify best practices.
Advise in the development of tools to assist in product reimbursement.
Communicate reimbursement hurdles to the Field Sales Team specific to their territory.
Replimune is dedicated to revolutionizing cancer treatment with therapies designed to activate a powerful and durable full-body anti-tumor response. They are an innovative and collaborative company that values its employees and offers opportunities to contribute to meaningful work that could impact patients' lives.
Lead one of Rula’s most critical operational functions.
Own end-to-end credentialing and enrollment outcomes.
Partner across the company to ensure providers are credentialed and enrolled accurately, compliantly, and efficiently.
Rula is dedicated to treating the whole person, not just the symptoms and aim to create a world where mental health is no longer stigmatized or marginalized, but rather is embraced as an integral part of one's overall well-being. Rula is a remote-first company that values diversity, equity, and inclusion.
Lead and develop a high-performing MSL team within a region, setting clear expectations for scientific excellence, compliance, and professional growth
Translate medical strategy into effective field execution, ensuring consistent, high-quality scientific engagement across territories
Ensure the timely collection, synthesis, and communication of actionable medical insights from the field to inform clinical development, medical strategy, and education planning
Compass Pathways plc is a biotechnology company dedicated to accelerating patient access to evidence-based innovation in mental health. They are pioneering a new paradigm for treating mental health conditions focused on rapid and durable responses through the development of their investigational COMP360 synthetic psilocybin treatment.
Act as the primary expert on transplant center operations, priorities, and strategic goals to inform product lifecycle decisions.
Partner with the Digital Portfolio PLM lead to enhance features, functionality, and value proposition of CareDx’s digital solutions.
Drive development of future wrap-around services and solutions that complement testing services and improve transplant outcomes.
CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. Every individual has a direct impact on our collective mission to improve the lives of organ transplant patients worldwide.
Execute US Market Access activities to optimize market access and commercialization.
Develop and execute national reimbursement, coding, and coverage strategies with government and commercial payers.
Maintain strong relationships with AWM cross-functional stakeholders to advance business objectives.
Smith+Nephew is a global medical technology company. They design and manufacture technology that takes the limits off living, supporting healthcare professionals to return their patients to health and mobility, helping them to perform at their fullest potential. The company embodies a culture of Care, Collaboration and Courage.
Lead a team of Customer Success Managers to achieve targets for retention and engagement for home care agencies.
Build and maintain strong relationships with agency partners, serving as their main point of contact.
Analyze data and develop reports to track progress and identify areas for improvement.
A Place for Mom is the leading platform guiding families through every stage of the aging journey by simplifying the senior care search. With over 15,000 senior living communities and home care agencies, APFM has helped millions of families find care since 2000 and employees live the company values every day.
Oversee provider credentialing, provider licensing, payer contracting, and network expansion.
Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs.
Manage relationships with credentialing and contracting vendors.
Sunrise Group is building the future of sleep health by combining innovative technology with expert care. They are a fast-growing team across the US and Europe, backed by more than $50M (€46M) from leading investors including Amazon’s Alexa Fund, Eurazeo, Kurma, and VIVES.
Provide leadership and guidance to multiple sales representatives on the Compliance Sales Team.
Develop and oversee the execution of advanced sales strategies that align with organizational objectives.
Drive significant revenue growth through innovative sales initiatives and market expansion.
Wolters Kluwer provides expert software and information solutions that the world’s leading professionals rely on, in the moments that matter most. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 21,400 people worldwide.
Coordinates home infusion services for compliance.
Organizes, plans, and evaluates agency services and programs.
Ensures effective delivery of services to maintain quality care.
BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Their compassionate care team helps patients navigate the often-challenging healthcare environment and treats their patients like family.
Manages clinical aspects of patient-centered medical home care.
Coordinates medical care of patients identified as high risk.
Identifies resources for patient self-management skills.
The University of Rochester is committed to fostering an inclusive and welcoming culture. They strive to uphold the values of equity, leadership, integrity, openness, respect, and accountability to set the highest standards for how they treat each other and ensure that their community is welcoming to all.
Set and execute Medicare agency strategy, partnering with the GM of Healthcare and Strategy & Ops to define a 3-year plan, annual OKRs, and a GTM strategy that drives 5–7x enrollment growth by 2026
Build and scale the brand and growth engine, partnering with Marketing to establish the agency brand and drive top-of-funnel demand across digital, advisor-assisted, and partner channels
Lead cross-functional operations and execution, aligning product, operations, and growth roadmaps while scaling efficiently through automation and AI
Propel empowers low-income Americans by simplifying access to government benefits with modern technology. They are a passionate team of 100 Propellers, all working to help their users get through the month, every month.
Lead a team of BHCMs, providing training and feedback to deliver evidence-based treatments.
Conduct direct patient care via Collaborative Care Model, including assessments and treatment plans.
Maintain licensure in home state and obtain licensure in other states as requested by Protocol.
Protocol Behavioral Health provides cancer-specific behavioral health treatment to patients by partnering with oncology clinics and cancer centers. They deliver high-quality mental health support for cancer patients using the collaborative care model, integrated directly into oncology treatment centers.
Serve as the Medicare coverage determinations and redeterminations subject matter expert.
Create and uphold robust policies and procedures for coverage determinations and redeterminations in accordance with CMS guidelines.
Recruit, onboard, train, and manage Medicare PA and Appeals pharmacists and technicians.
Judi Health provides a comprehensive suite of solutions for employers and health plans. Together with our clients, they’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.