Collective Health is hiring a

Medical Network/Pharmacy Integration Specialist

Lehi, United States

We all depend on healthcare throughout our lifetimes, for ourselves, and our families and friends, but it is notoriously difficult to navigate and understand. As an industry that comprises 20% of the US economy we think healthcare should work better for all of us. At Collective Health we believe it’s time for a new day in healthcare where as members we are informed and empowered to make the right care choices when the decisions are urgent and critical. 

Collective Health is expanding its Customer Experience team in Utah! We believe health benefits should be simple, accessible, and technology-driven. But moreover, we believe healthcare should be grounded by the people that it serves. To accomplish this, we are reimagining the operational core of health insurance. We are seeking passionate team members to help deliver on this vision. 

As part of the Member Services team within Customer Experience, the Plan Operations Department owns specialized processes that require close collaboration with Finance, Legal, Product, and other internal teams. We are hiring Network and Pharmacy Integration Specialists to integrate new strategic network and pharmacy partnerships on the CH platform. You will be responsible for planning and executing the project plan to create a great experience for our network and pharmacy partners, while ensuring serviceability for our Member Services teams. 

Key Responsibilities:

  • Project Management
    • Develop, manage and execute a detailed project schedule and work plan 
    • Provide project updates on a consistent basis to various stakeholders about strategy, adjustments, and progress
    • Measure project performance to identify areas for improvement
  • Delivering results:
    • Establish operational metrics internally as well as externally to measure operational health. 
    • Stand up and facilitate monthly/quarterly business reviews with network and pharmacy partners 
    • Ensure on time delivery and operational readiness for medical/pharmacy integrations
  • Process Improvement:
    • Drive scalability across function and processes within Plan Ops
    • Collaborate cross functionally to drive technology enabled solutions to enable the teams to scale. This includes partnering with teams across PM&D, Product, MX Readiness, Product Operations and other teams as needed. 
  • Escalation Management:
    • Establish clear escalation pathways between operational business areas and external partners. 
    • Appropriately triage escalations to determine appropriate stakeholders 
    • Establish robust operational relationships with external partners 

Skills and Qualifications:

  • 3+ years progressive work experience
  • Health insurance experience/health plan administration experience preferred
  • Experience implementing complex processes and projects
  • Experience working cross-functionally with Legal, Engineering, Product and Customer-facing teams
  • Experience working with various stakeholders including partners
  • Strong communication skills, both written and verbal
  • Ability to make progress and recommendations despite ambiguity
  • Ability to understand, analyze and envision the end-to-end process

Founded in 2013, Collective Health has created an ecosystem of innovative partners across care and benefits delivery, as well as built a powerful and flexible infrastructure to better enable employees and their families to understand, navigate, and pay for healthcare. By reducing the administrative lift of delivering health benefits, providing an intuitive member experience, and improving health outcomes, the company guides employees toward healthier lives and companies toward healthier bottom lines. Collective Health is headquartered in San Mateo, CA with locations in Chicago, IL, and Lehi, UT. For more information, please visit collectivehealth.com.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact [email protected].