
CareMetx, LLC
Remote Jobs
Patient access at the speed of flight
39 Jobs
• Under the general direction of the designated manager, the Patient Services Senior Manager is responsible for the successful delivery of all contracted services of respective Patient Services programs. • Provide program operational oversight, administration and management of one or more operational programs. • Lead an operational team of managers and associates by establishing goals and expectations for team oversight, setting direction and influencing team performance through the development and coaching of managers. • Ensure the program is operating in accordance to client service levels, compliance standards and operational efficiency. • Work with the client to provide program updates, regular reporting, and address client issues. • Collaborate with the Director and New Business Development on new business initiatives as well as in offering creative solutions to expand service offerings to clients. • Serve as the primary liaison between company and client as it relates to program operations; lead client operational meetings; field client questions and requests; interpret client needs and develop appropriate action plan; work with management team to monitor, assess and identify strategies to improve program processes, services, systems and analysis; engage with appropriate client contacts to provide proactive updates, address concerns and explore program opportunities and provide internal advocacy for client. • Work with management team to ensure that team is meeting contractual obligations and to seek ways to improve operational performance; identify staffing needs and work with HR to recruit appropriate staffing; serve as the interface for cross functional activities; work with team management to design programs to maintain high motivation among team members; manage overall program performance including pending work and proactively manage bottlenecks by shifting resources; responsible for establishing and monitoring goals for the team; ensure Managers are effectively managing individual productivity, quality and compliance; conduct performance reviews and quarterly talent reviews of management team; provide training and mentoring to team members and conduct career development discussions; hold regular meetings with team and one-on-one meetings with managers; provide coaching and guidance to leaders and partner with Human Resources in the resolution of associate relations issues. • Translate organizational strategies into team goals; lead training sessions; mentor managers; develop plans to facilitate growth and development for team members; help identify potential opportunities for team members; conduct quarterly talent review, coach and counsel managers and assistant managers and help prepare them for next level. • Work in coordination with Director to include managing monthly budget and expenses; complete follow-up on outstanding invoices; may participate in budget development; apply key financial indicators (i.e., operating income, revenue, ROCC, and Flash) to help measure program financial performance. • Explain to clients how we ensure and track quality; manage quality trending; implement and ensure that processes are in place to monitor quality and program compliance; collaborate with Compliance team on program audits; ensure ongoing program compliance to policies and procedures; work with leadership team to address audit findings and to implement corrective action. • Support company initiatives; exemplify core values; accept and effectively communicate decisions on company policies, plans and programs; ensure open communication at all levels; and reward appropriate behavior. • May collaborate across various groups (i.e. IT, PMO, NBD) on program projects, new service line implementations, database updates, UAT. May require travel to attend client meetings, training, or to support team members across multiple offices. • Performs related duties as assigned.
• Provides senior leadership on multiple client accounts or practice areas. • Responsible for strategic management. • Creates mission and works with management team to ensure a clear understanding of team mission and goals. • Works with management team to help identify skills that are needed for projects or work activities and match skill requirements with talent. • Develops performance standards for management team and measures success against performance standards. • Creates innovative business expansion and/or new services. • Responsible for lead proposal writing, contracting, client presentations, and pricing. • Establishes goals for business unit growth. • Stays abreast of industry trends and important pending legislation impacting business. • May maintain specialized technical skills in a disease state, hold expert medical knowledge on reimbursement strategies, and/or possesses functional knowledge. • Identifies and collaborates with internal and external resources and experts. • Develops succession plans for key management team members. • Recruits, trains and develops senior leaders. • Provides leadership to team and participates as facilitator for learning programs. • Manages budget to include P&L responsibility. • Approves purchases, contracting, expenses, and may manage vendor relationships. • Allocates human and financial resources as appropriate to ensure objectives are accomplished. • Searches and pursues revenue generation opportunities and effectively manages to ensure that new revenue is realized. • Trains managers on financial matters related to performing job responsibilities. • Overall responsibility for timeliness, accuracy, and completeness of all services. • Identifies areas for risk; fosters proactive, continued quality improvement. • Ensures and maintains highest integrity and honesty in all business activities. • Responsible for corporate culture to include embracing and fostering company values. • Supports company programs and initiatives; adheres to company policies and procedures. • Represents the company to associates and the public.
• Managing day-to-day operations of CareMetx Internal Systems • Mentoring and providing guidance to Service Desk team • Managing vendor contracts • Creating reports for End-User-Services (EUS) • Developing recommendations for process improvements • Cross training with other System Engineers • Leading small IT Projects • Presenting new projects or initiatives to Senior Leadership • Designing, implementing, and troubleshooting call center telephony systems • Proficient understanding of technology areas such as Azure Active Directory, MS InTune/MDM, Single Sign On/MFA • Experience deploying and administering SaaS based cloud applications • Providing technical support to applications and utility developers • Responsible for backup and recovery of all IT infrastructure • Ensuring system documentation is maintained • Interacting with Tier 1/2 service desk to troubleshoot user and system issues. • Providing after-hours infrastructure support, as needed.
• The Solution Architect II (SA II) role within the Implementations team independently designs and documents end-to-end solutions for CareMetx products and services. • This role translates client program needs into operationally feasible, compliant, and scalable hub workflows with minimal guidance, applying growing expertise in solution design and healthcare hub operations. • The SA II leads program discovery activities, drives the Implementation SOW process, and serves as a reliable solution contributor from Sales through Implementation go-live, while actively pursuing Senior SA responsibilities, competencies, and skills. • Independently defines technical program solutions, timelines, and scope for standard CMTX offerings, with a solid understanding of client goals and CMTX organizational strategy. • Partners with Product Management and Commercial team to coordinate cost/pricing inputs for the pricing model during the opportunity deal stage, ensuring costs submitted reflect solution scope, complexity, and staffing requirements. • Map client requirements to standard hub operational capabilities, technology platforms, and workflows. • Design end-to-end operational workflows covering all medical, pharmacy, and adherence services. • Partner with Product Management to identify gaps between client expectations and standard CMTX offerings; document assumptions, constraints, out-of-scope items, and feasibility risks. • Lead requirements intake and workflow design sessions with internal operational, technical, and compliance stakeholders. • Facilitate program design reviews and obtain internal and external review and signature for the Program Rules Document. • Support client escalations during implementation as they relate to solution and scope management, escalating complex issues to senior architects as appropriate. • Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled.
• Own the delivery roadmap for your branch, ensuring alignment with organizational strategy and market needs • Define and sequence work across multiple development teams in coordination with your POs • Prepare branch-level inputs for weekly, monthly, and quarterly roadmap assessment cadences • Make sequencing tradeoff recommendations to the Sr Director when initiatives compete for capacity • Track delivery progress against committed roadmap items and surface risks early • Coordinate cross-team dependencies within your branch and across branches • Facilitate cross-functional alignment sessions involving Product Management, Engineering, Operations, and Client Delivery • Ensure operational intelligence from hub programs is incorporated into roadmap planning • Partner with the peer Senior Manager on the other branch to resolve cross-branch dependencies and shared priorities • Manage a team of Product Owners and Business Analysts, providing coaching, career development, and performance feedback • Set clear expectations for PO performance, including the target of 75% strategic time allocation enabled by BA support • Conduct regular 1:1s, remove blockers, and ensure your team has the context and resources to succeed • Foster a culture of accountability, continuous improvement, and data-driven decision making within the team • Step into PO work when needed -- covering during absences, leading critical initiatives, or unblocking teams during complex sprints • Maintain sufficient technical and domain depth to credibly review PO work, validate acceptance criteria, and engage with engineering leads • Personally drive high-priority, cross-team initiatives that span multiple POs within your branch • Stay current with the product domain, technology stack, and operational context of your branch • Represent your branch in leadership reviews, QBRs, and cross-organizational planning sessions • Communicate roadmap progress, delivery risks, and strategic recommendations to PE leadership • Collaborate with Product Managers to ensure PM strategic intelligence is translated into actionable roadmap items • Coordinate with Client Delivery and Operations to ensure product decisions account for implementation and operational realities
• Use effective listening and communication skills to support patients via phone and other support channels • Provide patient and/or caregiver support to address patient questions and concerns utilizing approved talking points • Build trust-based patient relationships based on empathy • Engage each patient to overcome barriers to adherence • Document and maintain records of interactions via a CRM platform • Utilize motivational interviewing and cognitive behavioral therapy techniques • Participate in quality monitoring process to ensure high-quality support • Protect confidential patient health information in accordance with HIPAA Standards
• Collects and reviews all data to the degree authorized by the SOP of the program. • Coordinates services with the specialty pharmacy and national account manager. • Maintains frequent phone contact with pharmacy staff and manufacturer client. • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. • Provides training and support to inter-departmental associates. • Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate. • Independently and effectively resolves complex accounts with minimal supervision. • Demonstrates an understanding of complicated data issues. • Handles complex issues where analysis of situations or data requires an in-depth evaluation of variable factors. • Exercises judgment in selecting methods, techniques and evaluation criteria for obtaining results of pending shipments and incomplete data sets. • Networks with key contacts outside own area of expertise. • Acts independently to determine methods and procedures on new or special assignments. • Performs related duties and special projects as assigned. • Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled. • Performs other related duties as assigned.
• Coordinate and schedule interviews across multiple time zones and teams • Act as the primary point of contact for candidates throughout the interview process • Manage applicant tracking system (ATS) data entry, updates, and reporting • Prepare offer letters, initiate background checks, and manage pre-employment onboarding tasks • Partner closely with Talent Acquisition team members to support sourcing initiatives • Assist with career fair planning, recruitment events, and employer branding initiatives • Maintain compliance with recruiting policies and procedures • Shadow and support recruiters in sourcing candidates
• Acts as a single point of contact and voice for all providers and patients • Works as a patient advocate and always demonstrates compassion • Serves as a patient advocate and enhances the caller/contact experience • Coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services • Manages case load depending on the parameters of the program • Collects and review all patient information, to the degree authorized by the SOP of the program • Validates completeness of all required information and provides assistance to provider and/or patient • Provide guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner • Determines patient’s eligibility and conducts patient enrollment activities (example patient assistance programs and copay assistance) • Performs reimbursement related activities such as benefit investigations, prior authorizations, appeals, etc. • Provide exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly • Maintain frequent phone contact with patients, provider representatives, third party customer service representatives and pharmacy staff • Provides reimbursement information to providers and/or patients • Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP) • Coordinate with inter-departmental associates as necessary • Work on problems of moderate scope where analysis of data requires a review of a variety of factors • Exercise judgment within defined standard operating procedures to determine appropriate action • Typically receives little instruction on day-to-day work, general instructions on new assignments • Extensive knowledge of HIPAA regulations and follows all company policies • Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled • Performs other related duties as assigned
• Work closely with Product Managers to develop product strategy • Maintain the team backlog and facilitate customer conversations • Participate in market research and analysis • Collaborate with UX designers, UI, and engineering teams
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