Jobs at MedImpact Healthcare Systems

Manages marketing project infrastructure, workflows, dashboards, reporting, intake, prioritization, timelines, risks, and cross-functional coordination. Oversees selected complex initiatives including conferences, product launches, campaigns, website projects, and events. Facilitates meetings, tracks decisions and action items, escalates issues, and delivers executive-ready reports on workload, capacity, resources, dependencies, and project status. Requires strong marketing operations and project management experience, proficiency with project management platforms, and the ability to influence stakeholders without direct authority.

Supports production and distribution operations by printing and distributing client communications, processing internal requests, completing Salesforce cases, maintaining process documentation, monitoring supplies and postage, and ensuring accuracy and timely completion of work in accordance with client, postal, CMS, and departmental procedures.

Develops, tests, documents, and deploys software under close supervision. Supports production systems, resolves technical issues, participates in project meetings, follows software engineering standards, and collaborates on process and Agile delivery. Works on APIs/microservices, web frameworks, databases, and DevOps tooling.

Serves as a quality management subject matter expert for Medicaid and Fee-for-Service programs. Establishes quality standards and governance, evaluates regulatory requirements, leads root cause analyses and continuous improvement, oversees quality activities and deliverables, supports implementation readiness, and advises cross-functional teams. Develops training and documentation while ensuring compliance with contractual, PBM, and CMS requirements.

Lead underwriting and economic strategy for complex trade and emerging market initiatives. Develop business cases, financial models, pricing and margin analyses, and underwriting frameworks. Partner cross-functionally and with vendors to align contracts, implementation readiness, and performance tracking. Provide executive recommendations, run cross-functional workgroups, and manage a team with responsibility for coaching, prioritization, and performance management.

Designs, develops, delivers, and evaluates internal training programs, e-learning content, instructional materials, and new-hire training. Translates complex technical and regulatory information into accessible learning experiences using instructional design methodologies and multimedia tools. Collaborates with subject matter experts, supports client training, monitors learner progress, maintains learning resources, and identifies emerging training needs related to Medicaid and company programs.

Designs, develops, delivers, and evaluates internal and client-facing Medicaid and Government Programs training. Creates e-learning, instructor-led materials, guides, job aids, assessments, multimedia content, and curricula using instructional design methodologies. Collaborates with subject matter experts, facilitates training, supports new-hire development, maintains learning repositories, monitors learner progress, and tracks Medicaid regulatory updates. The role requires client interaction, strong communication, and domestic travel up to 20%.

Executes accreditation, clinical quality, utilization management, and UR licensure activities across MedImpact’s business lines. Conducts audits, analyzes data and case files, maintains compliance documentation, monitors delegated entities, supports regulatory and client audits, develops reports, and tracks corrective actions. Serves as a subject-matter expert on NCQA and URAC standards, provides training and consultation, supports committee activities, and coordinates accreditation deliverables with internal, delegated, and client-facing teams.

Performs clinical quality audits of prior authorization, appeals, and utilization management staff and delegates. Develops audit programs, inter-rater reliability testing, quality reports, and compliance documentation aligned with NCQA, URAC, CMS, regulatory, and client requirements. Identifies process gaps, supports corrective actions and accreditation activities, evaluates clinical guideline appropriateness, and communicates findings to leadership, clients, and oversight committees.

Supports FP&A, financial reporting, month-end close, forecasting, budgeting, long-range planning, variance analysis, and management reporting. Builds and maintains financial models, dashboards, KPI reports, and reporting packages; validates and reconciles financial and operational data; analyzes business drivers, profitability, expenses, and risks; prepares commentary for leadership and audit activities; and partners with internal stakeholders using Hyperion EPM and related tools.

Manages clinical quality monitoring, retrospective audits, delegation oversight, inter-rater reliability, corrective actions, and regulatory compliance across utilization management operations. Leads multidisciplinary clinical and quality staff, validates prior authorization metrics, analyzes trends and root causes, supports NCQA and URAC accreditation, and presents findings to executives, clients, regulators, and governance committees. Requires active pharmacist or registered nurse licensure, managed care or PBM experience, and substantial supervisory leadership.

Manages clinical products and services throughout their lifecycle, including business analysis, product development, implementation, project management, process improvement, billing reconciliation, and client support. Leads cross-functional teams, documents requirements, monitors deliverables, supports sales opportunities, manages vendors and communications, and develops recommendations for clinical program and workflow improvements within a pharmacy benefits management organization.

Provides legal counsel and regulatory compliance oversight across Medicare, Medicaid, Marketplace, and commercial healthcare operations. Tracks and interprets state and federal laws, licensing requirements, and regulatory guidance; leads examinations, audits, governmental inquiries, and corrective actions. Advises executives and business stakeholders on regulatory risks, policies, compliance strategies, and emerging developments. Coordinates with Legal, Compliance, Privacy, and operational teams and supports governance committee materials.

Provides clinical, analytical, and operational support for pharmacy benefit management programs. Analyzes formulary, utilization, drug cost, rebate, and clinical quality data; supports Medicaid Preferred Drug Lists, DUE/DUR/QI programs, client recommendations, formulary maintenance, and P&T Committee activities. Collaborates with internal teams and external clients to improve clinical outcomes and financial performance while ensuring compliance with HEDIS and NCQA guidelines.

Performs advanced accounting, financial reporting, complex reconciliations, journal entries, month-end and year-end close activities, budgeting, forecasting, audits, and lender reporting. Reviews work prepared by less experienced accountants, provides mentoring, supports GAAP compliance, leads process improvements, and coordinates with auditors, management, international subsidiaries, and external professionals. The role also assists with tax filings, cash flow reporting, financial briefings, and accounting projects.

Manage complex, strategic client accounts for a PBM, driving retention, renewals, upsells and profitability. Build executive relationships, create financial/pricing models and business plans, lead client meetings, oversee implementations, escalate service issues, mentor junior AEs, and collaborate cross-functionally to meet contractual and financial goals.

Leads the design, development, implementation, and support of business intelligence solutions, including dashboards, reports, data models, pipelines, and reporting frameworks. Translates complex business requirements into scalable data solutions, ensures data quality and HIPAA compliance, resolves technical issues, evaluates emerging technologies, and mentors team members. The role manages staff, leads projects, partners with internal and external stakeholders, and communicates technical concepts to business and executive audiences.

Manages clinical and analytical aspects of drug rebate programs, advising clients on HCPCS/NDC billing, rebate edits, utilization, unit conversions, and CMS dispute processes. Conducts provider audits and education, analyzes claims for billing inaccuracies, produces financial and drug utilization reports, supports 340B initiatives, and recommends interventions to improve rebate data integrity, cost effectiveness, and client outcomes. The role is client-facing and requires collaboration with internal stakeholders and external clients.

Manages healthcare client relationships and serves as the primary clinical contact for assigned PBM accounts. Leads clinical program implementation, provides guidance on formulary management and drug utilization, analyzes clinical performance and cost savings data, prepares client reports, ensures regulatory compliance, and collaborates with sales, operations, and account management teams. The role requires a PharmD, active pharmacist licensure, PBM knowledge, strong communication skills, and up to 25% domestic travel.

Leads enterprise infrastructure and IT operations across on-premises data centers and cloud environments. Oversees servers, storage, databases, networks, virtualization, end-user computing, disaster recovery, cybersecurity coordination, service delivery, vendor management, budgets, compliance, and infrastructure modernization. Manages technical teams, ensures 24x7 availability and operational resilience, drives automation and lifecycle management, and serves as an executive escalation point for infrastructure and service issues.