6 senior clinical quality analyst jobs found

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Senior Data Operations Engineer is responsible for the integrity and flow of the AffirmedRx data ecosystem. This role manages end-to-end technical onboarding for client data, automates ingestion pipelines, and resolves complex data discrepancies. You will act as the primary technical bridge between raw client data and our internal analytics environment, ensuring all data is mapped, validated, and accessible. What you will...

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Director of Utilization Management (UM) is a senior clinical and operational leader responsible for strategy, design, execution, and continuous improvement of Prior Authorization and utilization management programs. This role owns UM outcomes across clinical quality, regulatory compliance, operational performance, financial impact, and client experience. The Director will build and lead a high-performing UM organization,...

About Integrated Specialty Coverages Integrated Specialty Coverages, LLC (ISC) is a growth stage technology and data-driven commercial MGA and insurance wholesaler leading innovation in the market.   Backed by one of the leading private equity firms, Onex Partners, and led by a forward-thinking management team, ISC is combining the worlds of insurance and technology to create an Insurtech powerhouse. As a leading online distributor of insurance products for a range of industries and “Main Street USA”, we are looking for the right people to help us in our mission of achieving exponential growth. We strive to be the number one place to go for brokers and agents to source insurance. To accomplish this, we’re building a digitally focused team that deeply understands the intersection between user experience, data, and AI/ML to optimize the way we engage with our customers and partners. Job Summary The Business Unit Leader will focus on Small Business Package Solutions and...

Who is Cover Whale? Cover Whale is the nation’s leading commercial trucking insurtech. We improve road safety by combining the insurance products we sell with our telematics-based, data-driven driver coaching and safety program known as DriveSmart. Our program is proven to save lives while delivering better insurance for our drivers. For more information, please visit www.coverwhale.com .  Join us in the mission! The Role:  Cover Whale is seeking a high-energy, results-oriented Production Business Relationship Manager (PBRM) to serve as the critical "Operator" in our distribution engine. While our Business Development Associates (BDAs) hunt for new business and our Business Development Managers (BDMs) architect portfolio strategy, the PBRM is the bridge that ensures every indicated dollar has a path to binding. The mission of this role is to maximize the conversion of indicated and quoted opportunities into bound premium by proactively managing the post-indication...

Grow With Us!  At Hilb Group, we recognize that our associates are our greatest asset. We promote a service-driven culture of high performance that encourages career and professional development. The Hilb Group is currently seeking a motivated and ambitious Benefits Marketing Manager to join our team. The ideal candidate will be motivated to succeed, is well organized, able to prioritize, and able to work well with a team. This is a remote position. Responsibilities: Responsible for Content Strategy & Planning, driving and maintaining the HRC content calendar to ensure consistent, timely, and high-quality content delivery. This includes balancing frequency to prevent audience fatigue and unsubscribe rates, while ensuring clients receive notifications at least 90–120 days in advance of foreseeable compliance regulation implementation dates. Lead end-to-end content development, including strategy, writing, editing, proofreading, and publishing of HR...

About COVU COVU is a venture-backed technology startup transforming the insurance industry. We empower independent agencies with AI-driven insights and digitized operations, enabling them to manage risk more effectively. Our team is building an AI-first company set to redefine the future of insurance distribution. Location: This role can be hybrid or remote. If the candidate is based in the Los Angeles (LA) area, it will be a hybrid role working from our office in West Hollywood. For candidates based anywhere else in the US, this will be a fully remote role. Role Overview  We are seeking an experienced and product-focused Senior Data Engineer to be a core member of our Platform product team. This is a high-impact role where you will play a pivotal part in evolving our core data infrastructure. Your primary mission will be to develop key components of our "Policy Journal" - the foundational data asset that will serve as the single source of truth...