Top Tech Jobs & Startup Jobs

Assists with actuarial rate determination, statistical analysis, pricing, valuation, and forecasting models. Collects, validates, and refines data; applies actuarial tools; and communicates findings and recommendations to colleagues, business partners, and leadership. The role requires a bachelor’s degree and at least one SOA or CAS actuarial exam, with additional exams, analytical programming experience, and healthcare interest preferred.

Lead design, development, and deployment of scalable ML and reinforcement learning systems for healthcare outcomes and decision intelligence. Direct research projects, publish findings, mentor teams, and partner with engineering and product to operationalize AI/ML solutions using healthcare claims data. Ensure quality, regulatory alignment, and measurable operational impact.

Leads end-to-end development and maintenance of enterprise platforms and automation solutions. Gathers requirements, reviews designs and code, manages enhancements and change requests, ensures testing and implementation, oversees monitoring and on-call support, and coordinates technical environments. The role also improves system stability, scalability, and operational efficiency; leads major projects and JAD sessions; evaluates vendors; and mentors or supports other engineers.

Leads end-to-end development and maintenance of enterprise technology platforms. Responsibilities include gathering requirements, reviewing designs and code, coordinating testing and releases, managing change requests, supporting system monitoring and on-call operations, improving scalability and stability, creating enablement materials, mentoring teammates, and evaluating vendors. The role partners with customers, business stakeholders, web and marketing teams, and cross-functional technology groups to deliver scalable solutions and drive adoption.

Provides day-to-day technical direction and operational support to claims, customer service, membership, and operations associates. Responsibilities include workflow guidance, training, answering technical questions, complex case resolution, inventory monitoring, records maintenance, policy and procedure review, and coordination with training teams. The role requires multitasking across calls and digital queues, strong communication, problem-solving, empathy, attention to detail, and flexibility for occasional overtime and onsite work.

Assists with actuarial rate determination through statistical and actuarial analysis. Updates pricing, valuation, and forecasting models; collects, refines, validates, and reconciles data; documents actuarial experience reports; and supports audits by explaining models and providing supporting details. Requires a bachelor’s degree and at least one SOA or CAS actuarial exam pass, or equivalent education and experience.

Leads complex federal and state mandate projects from planning through closure, ensuring regulatory compliance, quality, cost, scope, schedule, and risk management. Develops project strategies, requirements, training plans, approval matrices, quality gates, service-level agreements, and vendor contracts. Coordinates implementation and post-implementation activities, manages global resources, and mentors project managers and project team members. The role supports projects affecting Medicaid, Medicare, commercial business lines, and multiple organizational functions.

Leads enterprise non-human identity and privileged access management initiatives, including platform implementation, architecture, discovery, inventory, identity classification, remediation, integrations, and adoption planning. Develops access management and network security solutions, risk assessments, incident response strategies, security requirements, and technical roadmaps. Serves as a subject matter expert, technical escalation point, vendor strategist, and potential merger and acquisition security lead.

Leads pharmacy benefit management client accounts and PBM vendor contracts across the West Region. Oversees contract strategy, pricing, rebate analysis, network compliance, policy implementation, and client satisfaction. Manages account executives and account managers, including hiring, coaching, performance evaluation, and career development. Builds relationships with vendors and stakeholders, supports retention and upselling opportunities, negotiates expectations, and presents recommendations to senior executives. Travel to meetings and events is required as needed.

Develops and executes CarelonRx sales strategies across assigned territories, targeting commercial ASO clients with 250+ members. Leads complex account sales, prospecting, broker and consultant engagement, pharmacy pricing, RFP execution, finalist meetings, pipeline forecasting, and market intelligence initiatives. Partners with implementation teams to ensure successful client transitions and communicates CarelonRx solutions to plan sponsors and external stakeholders.