Top Tech Jobs & Startup Jobs

Leads process improvement and continuous improvement initiatives within FEP clinical and utilization management operations. Identifies performance opportunities, researches and implements best practices, develops metrics, serves as an internal consultant, and creates enterprise-wide improvement plans. Requires strong analytical, communication, leadership, project management, business analysis, and advanced Excel skills, with experience in Agile delivery and relevant FEP systems preferred.

Advises business leaders on business continuity and resilience, develops risk assessment methodologies, designs continuity strategies and incident response plans, leads framework implementation, facilitates recovery exercises, and supports response during disruptions. Modernizes resilience capabilities through emerging technologies, including generative AI, while coordinating enterprise stakeholders and producing management reports.

Translates complex PBM business needs into software requirements and solutions. Leads analyst teams, conducts claims and business impact analyses, investigates operational issues, performs root cause analysis, evaluates risks, develops remediation recommendations and business cases, and presents findings to leadership. Partners with Operations, Product, Technology, Finance, Compliance, and Client Services to improve processes, strengthen controls, and support PBM operations initiatives, compliance, audits, and contractual obligations.

Leads enterprise-wide continuous improvement initiatives using Lean Six Sigma, process optimization, and operational excellence methods. Identifies improvement opportunities, develops best practices and performance metrics, provides internal consulting, and drives cross-functional implementation. Directs project teams, develops data-driven recommendations, manages multiple initiatives, and presents executive-level insights. Requires significant process improvement, project management, business analysis, and leadership experience, with healthcare payer experience and Lean Six Sigma expertise preferred.

Lead design, deployment, and operational support for enterprise data protection across hybrid cloud and on-prem. Focus on encryption, tokenization, key management, HSM operations, integrations with apps and storage, automation via IaC, incident response, vendor strategy, and troubleshooting. Partner with application and infrastructure teams to ensure secure, stable production data protection and compliance.

Develops and maintains complex enterprise applications, including RESTful APIs and user interfaces. Defines API contracts, evaluates requirements, implements secure and scalable software, performs testing and defect resolution, supports system integration and production operations, and provides on-call support. Collaborates with stakeholders, engineers, designers, and QA teams while mentoring developers and conducting code reviews.

Leads executive account management for a complex Maryland Medicaid behavioral health contract. Owns P&L performance, client relationships, operational excellence, contractual compliance, retention, revenue growth, and expansion opportunities. Partners with state leaders and cross-functional teams across clinical, operations, network, quality, finance, and product functions. Oversees and develops direct reports while driving accountability, customer satisfaction, strategic initiatives, and innovative behavioral health solutions.

Assists with Medicaid pricing and rate determination by applying actuarial and statistical analysis, updating pricing, valuation, and forecasting models, and collecting, validating, and refining data. Supports the Medicaid Pricing lead with rate impact development, projections, and related actuarial analyses under limited supervision.

Provides enterprise-wide legal counsel on technology matters, including AI, SaaS, software as a medical device, data use, and digital health product development. Negotiates technology agreements, advises sales teams on RFPs, assesses regulatory risks, develops contract templates and negotiation playbooks, and supports risk mitigation, strategic legal analysis, and internal education.

Leads enterprise strategic planning, executive communications, performance management, governance, and operational coordination for a Health Benefits Operations portfolio. Partners with the COO’s office and corporate strategy teams, conducts healthcare research, develops executive materials, manages special projects, evaluates investment decisions, and supervises direct reports. Requires extensive project management and healthcare policy or legislative analysis experience, strong executive presence, and the ability to coordinate complex cross-functional priorities.