Claritev
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At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
69 Jobs
Business Analyst
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description The incumbent works with members of Claritev's business units to elicit, organize and document business requirements to ensure that the project team can develop solutions that meet the customer's real needs; minimize requirement defects up front, establish and maintain agreement between the customer and project team on requirements for the project deliverables. Job Roles and Responsibilities: - Conduct meetings with business stakeholders to actively solicit, analyze and negotiate customer requirements. - Manage multiple priorities, customer expectations and relationships with all stakeholders including IST staff and business staff. - Solicit input from developers and other IST technical staff to determine project scope and provide estimate of level of effort. - Work with project team to develop cost effective, customer focused solutions. - Conduct walkthroughs with applications development staff as handoff from analysis to development in life cycle. - Work with applications development staff during the technical design, programming and unit-testing and implementation stages. - Coordinate changes to functional specifications that occur during development and updates functional specifications as required. - Work independently on small, medium and large-sized projects with low to medium complexity. - Support customer in training efforts for end users and staff members. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate commitment to the Company's core values. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role. Qualifications - Minimum Bachelor's Degree in AI, Computer Science, Healthcare Informatics, or a related field, or 4 equivalent years of related experience. - Minimum 2 years experience in business analysis or system design for AI-driven analytics, automation, healthcare data solutions, or software development initiatives in analyst role (preferably within a Scrum Agile team). - Experience in Agile methodologies (Scrum, Kanban) and requirements gathering (e.g. BDD, user stories) and backlog refinement. - Familiarity with Agile knowledge management tools such as JIRA and Confluence preferred. - Knowledge of business process modelling tools such as Visio, Lucidcharts, Draw.io preferred. - International Institute of Business Analysis (IIBA) certifications, AAC, CBAP or CCBA preferred. - Business Analysis certifications (CBAP, PMI-PBA) or AI/ML-related certifications are preferred. - Experience with data visualization tools (SQL, Tableau) to analyze AI driven insights is a plus. - Strong understanding of healthcare workflows including claims processing. Experience working with healthcare data sources. - Excellent verbal and written communication skills with technical and non-technical stakeholders. - Analytic, organization, interpersonal, prioritization, multi-tasking, initiating, communication, planning and technical skills. - Ability to use software and peripherals related to performance of job responsibilities. - Ability to facilitate teams and client relationships to satisfy needs and identify improvements. - Ability to develop strong relationships with all levels of management. - Ability to demonstrate commitment to excellent customer service and follow through. - Ability to manage multiple simultaneous initiatives including continuous evaluation and re-ordering of priorities for self and staff as business needs dictate. - Ability to effectively present information and respond to questions from internal and external customers. - Ability to be flexible and creative in problem solving and identifying process improvements. - Ability to anticipate business needs and think with a business owner mind-set. - Ability to recognize and apply business analysis and system analysis best practices to fit a variety of situations. - Strong problem-solving skills, ability to prioritize tasks, and work in a fast-paced, cross-functional team. Requirements - The salary range for this position is $80-100K. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. - This position is also eligible for health insurance, 401k and bonus opportunity. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year. Company Description Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status.
Sr. Scrum Master
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description Sr. Scrum Master position is a servant leader of highly collaborative development team practicing Agile and delivering to the business in an iterative manner, using Agile best practices, continuous improvement, and leading without authority. Ideal candidate enjoys fast-paced environment, thrives under ambiguity and embraces change passionately. They help their team adopt and improve on their application of Agile methodology. They continually support team goals and remove obstacles while ensuring that they adhere to overall program-level ways of working. The candidate has high energy in team settings, and is an innovative thinker. Job Roles and Responsibilities - Facilitate Scrum ceremonies for two or more Scrum teams and/or programs, such as Sprint Planning, Daily Stand-ups, Sprint Reviews, and Retrospectives - Proactively find ways to enable the team to become high performing, predictable, empowered and self-organized - Serve as a strong facilitator, leading team- and program-level sessions including PI Planning, dependency alignment, and execution workshops - Proactively identify, track, and manage cross-team dependencies, risks, and impediments, ensuring continuity of delivery across workstreams - Coach and guide the team in Agile delivery best practices, foster an agile mindset and a culture of continuous improvement - Measure team delivery maturity and performance, and review the metrics with the team to identify improvement opportunities - Define, track, and report KPIs, metrics, and program health, providing actionable insights through sprint and program-level analysis - Provide clear, concise, and effective communication to leadership and executives, including status, risks, and key decisions - Support release planning and deployment activities, ensuring coordination across teams and stakeholders - Drive assigned continuous improvement initiatives at the team and program levels - Participates in the Scrum Master Community of Practice sharing ideas, observations and opportunities for improvement - Possesses a competency for change management principles and has practical experience in coaching teams through change Job Scope Incumbent works under minimal direction and uses independent judgment to identify issues, trends & problems and recommend action plans and evaluate results on projects that may not be clearly defined. Work is varied and complex, requiring the individual to use a broad range of knowledge gained through prior Scrum Master experience. The position works with internal and external sources to complete objectives, keeping the needs of external and internal customers as a priority when making decisions and taking action. Qualifications - Minimum Bachelor’s Degree in IT or Computer Science, or 4 years of related experience - Minimum of 5 years as a Scrum Master experience, including leading multiple Agile teams and/or programs - Scrum Master Certification desired but not required - Experience with Scaled Agile Frameworks required; SAFe experience a plus - Knowledge of other Agile approaches, such as Kanban - Hands-on experience with Jira software in an IT environment - Knowledge of Healthcare industry preferred - Communication (oral, written and listening), project management, analytic, organization, interpersonal, prioritization, multi-tasking, initiating, communication, planning and technical skills - Exceptional executive communication skills, with the ability to effectively present to the business and leadership - Proven experience in dependency management across teams, systems, and stakeholders - Ability to develop and maintain collaborative and cooperative relationships throughout the organization - Strong expertise in facilitating teams, including leading large-group sessions such as PI Planning and program reviews - Ability to demonstrate commitment to excellent customer service and follow-through - Ability to manage multiple simultaneous projects including continuous evaluation and re-ordering of priorities as business needs dictate - Ability to effectively present information and respond to questions from leadership, internal and external customers - Ability to be flexible and creative in problem solving and identifying process improvements - Ability to anticipate business needs and think with a business owner mind-set - Ability to adhere to corporate work ethic standards Compensation The salary range for this position is $120-130k. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. Benefits - Medical, dental and vision coverage with low deductible & copay - Life insurance - Short and long-term disability - Paid Parental Leave - 401(k) + match - Employee Stock Purchase Plan - Generous Paid Time Off – accrued based on years of service - 10 paid company holidays - Tuition reimbursement - Flexible Spending Account - Employee Assistance Program - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits EEO Statement Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. Application Deadline We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
Temporary Provider Data Analyst
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description This role maintains provider demographic data within the organizationally utilized database environment. The incumbent will regularly add and edit participating provider records in accordance with organizational and network processing guidelines. - Analyze, research, and input relevant data for providers added to the organization’s network through individual contracts, facility/ancillary contracts and/or newly acquired group contracts. - Maintain changes to current provider files including provider terminations. - Update provider records including practitioner, facility, ancillary, and group records. - Obtain missing data and update provider profiles specific to provider directory and/or client data extracts. - Research and respond to all ad hoc requests (status checks) from both internal and external customers. - Fully update provider profiles as appropriate while assuring continual adherence to established operational guidelines. - Identify issues that require additional investigation and evaluation, validate discrepancies incurred and ensure appropriate follow up. - Refer complex issues to management for appropriate disposition. - Complete special projects as assigned by management, including both telephonic and electronic investigative work. - Verify, research, and respond to telephone inquiries and written inquiries from providers and other departments pertaining to provider participation in a professional and courteous manner. - Partner cross-functionally as necessary to ensure accurate and efficient disposition of data investigations and maintenance work. - Ensure systematic data-oriented efforts to improve consumer and/or client services. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company’s Core Competencies and values held within. Qualifications - Minimum High School Diploma and three (3) years of relevant experience; Bachelor’s degree in a related field is preferred. - Strong communication skills including written, verbal, listening, organization, telephone, interpersonal, analytical, and data entry skills. - Ability to be detail oriented. - Ability to work independently and adapt to various tasks. - Ability to meet quality and production goals. - Ability to use software, hardware and peripherals related to job responsibilities including Microsoft Office products. - Required licensures, professional certifications, and/or Board certifications as applicable. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitors for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. Requirements - Minimum High School Diploma and three (3) years of relevant experience; Bachelor’s degree in a related field is preferred. - Strong communication skills including written, verbal, listening, organization, telephone, interpersonal, analytical, and data entry skills. - Ability to be detail oriented. - Ability to work independently and adapt to various tasks. - Ability to meet quality and production goals. - Ability to use software, hardware and peripherals related to job responsibilities including Microsoft Office products. - Required licensures, professional certifications, and/or Board certifications as applicable. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitors for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. Benefits - The hourly range for this position is $20.00 - $27.00 per hour. - Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. Company Description At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Director of Client Success Growth Programs
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description The Director of Client Success is an empowered leader with deep knowledge of business and client needs, assisting the VP in curating product visions and roadmaps while collaborating with various agile teams from end-to-end to produce meaningful products. This role manages a team of Analytic Advisors to build strategies to retain and grow the customer base, while leveraging interactions to identify and solve for whitespace. Qualifications - Minimum bachelor's degree, preferably in Health Services or Business or a related field from an accredited 4-year college or university. - Minimum 5+ years insurance experience required, preferably health insurance experience in the self-insured plan arena. - Required licensures, professional certifications, and/or Board certifications as applicable. - Strong management presence and leadership ability, with communication and interpersonal skills that inspire and motivate leaders and teams. - Ability to manage multiple simultaneous initiatives including continuous evaluation and re-ordering of priorities as business needs dictate. - Experience with distributed (offshore and remote) teams. - Experience with working across multiple teams. - Experience with Scaled Agile Framework (SAFe). - Knowledge of Healthcare industry and understanding all major workflows associated with the healthcare claim processing is beneficial. - Communication (oral, written and listening), project management, analytic, organization, interpersonal, prioritization, multi-tasking, initiating, communication, problem-solving, planning, and technical skills. - Ability to be detail-oriented, while keeping the entire vision in mind. - Ability to establish strong working relationships with teams and client relationships. - Demonstrate commitment to excellent customer service and follow-through. - Ability to effectively present information and respond to questions from internal and external customers. - Ability to be flexible and creative in problem solving. - Ability to anticipate business needs and think with a business owner mind-set. - Ability to adhere to corporate work ethic standards. - Ability to facilitate teams and client relationships to satisfy needs and identify improvements. - Ability to develop strong relationships with all levels of management. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone. Requirements - Develop a team focused on customer success management and revenue retention, which will involve healthcare data analytics support and data structure consultation. - Cultivate product vision and prioritize roadmaps among various key stakeholders, to find new opportunities to better serve the marketplace. - Participate in the decision-making process for product enhancements and new features to ensure alignment with various user personas. - Participate in product design and product management and execute on the vision. - Define and optimize customer lifecycle by driving programs and initiatives to improve engagement approaches based on customer segmentation and leading a culture of continuous improvement. - Strive to reduce churn and drive new business growth. - Sustain business growth and profitability by maximizing value through innovative products, streamlined processes, and strategic client relationships. - May participate in analyzing client data, providing consultative insight. - Manage and resolve escalated client requests and complaints, to assist team members' development. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company's Core Competencies and values held within. - Please note due to the exposure of PHI sensitive data -- this role is considered to be a High-Risk Role. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.
Director of Vendor Management Operations
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description The incumbent has primary responsibility for all Commercially supported Vendor Team(s) including the areas of Registrar, Credentialing, Provider Data Management, Surprise Bill Services, NSA related Operations, and other claim supporting or regulatory functions as assigned. This role ensures the accuracy, quality, and reliability of operational processes, systems, and data across supported functions. The incumbent serves as an operational subject matter expert, supporting enterprise workflows, policy adherence, process optimization, and the integration of automation and efficiency initiatives. The role partners closely with Vendor(s) to manage performance, meet budget expectations, achieve operational metrics, and support continuous improvement. Additionally, the position evaluates and supports the onboarding of new vendor partners and may assume responsibility for additional operational areas as organizational needs evolve. Qualifications - Minimum bachelor's degree, or HS Diploma (or GED) and 4 years of related experience - Minimum 8 years' operations management experience, ideally managing healthcare provider data - Required licensures, professional certifications, and/or Board certifications as applicable - Knowledge of managed care business preferred - Knowledge of Vendor Management is required - Knowledge of the organization, products and systems preferred - Knowledge of general business principles, industry dynamics, market trends and specific operational details including Network Management and provider/provider group contracts preferred - Communication (written, verbal, listening), decision-making, judgment, analytical, team building, leadership, coaching, people management, multi-tasking, organizational, detail orientation, presentation, time management, problem solving and customer service skills - Ability to create, refine, implement and manage new and innovative processes - Ability to work effectively at detail and big-picture levels while moving projects forward - Ability to diffuse challenging situations and follow through with resolution - Ability to use software, hardware and peripherals related to job responsibilities including MS Office (Visio, Excel, PowerPoint and Word) - Ability to travel up to 25% - The individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone Requirements - Serve as subject matter expert on corporate and area projects and initiatives. - Oversee daily Vendor operations, including registrar activities, provider data maintenance, credentialing tasks, project work, ad hoc requests, and support for Surprise Bill/NSA related workflows and other operational functions as assigned. - Act as primary owner for all related KPI's, work with team to ensure compliance and constant improvement (both in terms of quality and turnaround time). - Serve as contact and subject matter expert for assigned areas with Legal on regulation issues affecting provider data and client deliverables. - Complies and assures compliance with all relevant governmental regulations and company policies. - Lead interdepartmental projects and serve as a member of multiple concurrent teams aimed at improving operations. - Design and implement business processes across assigned areas and maintain responsibility for ongoing business process engineering. - Develop short- and long-term strategies to support and align succession planning and business strategy. - Manage and monitor departmental budget and expenses. - Ad hoc support to Sr. Director and AVP, Operations as necessary. - Select, develop, and evaluate staff to ensure the efficient operation of department. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company's Core Competencies and values held within. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Benefits - Medical, dental and vision coverage with low deductible & copay - Life insurance - Short and long-term disability - Paid Parental Leave - 401(k) + match - Employee Stock Purchase Plan - Generous Paid Time Off – accrued based on years of service - 10 paid company holidays - Tuition reimbursement - Flexible Spending Account - Employee Assistance Program - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
RVP, Business Development-New Business
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description This role is responsible for establishing, developing and expanding our health benefit brokers, healthcare providers, employers, regional health plans, third-party administrator and/or payor relationships. The incumbent will develop sales strategies with a focus on net new business sales. Job Roles and Responsibilities - Establishes, develops and expands Healthcare Provider relationships. - Grows one's client base in a continuous manner. - Brings about and nurtures all related marketplace relationships. - Answers client questions about services, contracts while addressing any other concerns that arise. - Meets or exceeds sales goals established on a quarterly basis. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensures compliance with HIPAA regulations and requirements. - Demonstrates Company's Core Competencies and values held within. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Qualifications - Bachelor degree (BA/BS) from an accredited college or university preferred or equivalent experience and discipline. - At least ten (10) years of business development experience. - Provider Focused - Five (5)+ years of experience in employee benefit sales or equivalent disciplines. - Proven and demonstrated successful sales track record. - Experience in dealing with health benefits brokers, third party administrators and regional health plans. - Possesses exceptional multi-tasking ability. - Strong communication skills, both oral and written. - A high level of professionalism, organization and flexibility. - Advanced sales and negotiation skills. - Recognizes and maintains confidentiality of information as appropriate. - Working knowledge and experience using Salesforce. - Self-Motivating personality and a professional demeanor that promotes a team environment. - Willingness to travel, up to 75%. - Ongoing local-area market knowledge. - Ability to bring about and nurture marketplace relationships. - Able to work comfortably in a fast-paced environment. - Experience with Microsoft and Salesforce applications. - Required licensures, professional certifications, and/or Board certifications as applicable. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. - Regular, timely attendance. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.
Senior Applied AI Scientist
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description We are seeking a Senior Applied AI Scientist to lead the research, development, and deployment of advanced machine learning and AI systems that power Claritev’s next generation of healthcare products. This is a hands-on technical leadership role for an experienced applied scientist who thrives at the intersection of research innovation, real-world deployment, and measurable business impact. You will architect and deliver predictive, generative, and agentic AI systems that automate complex healthcare workflows and unlock new insights from large-scale healthcare data. In this role, you will work closely with Product, Engineering, and business leaders to translate cutting-edge research into scalable production solutions that improve transparency, reduce costs, and simplify healthcare operations. Key Responsibilities - AI & Machine Learning - Design, develop, and deploy machine learning and AI models in production environments. - Build predictive, generative, and optimization models to improve healthcare outcomes and operational efficiency. - Improve existing models and systems with measurable impact on performance, scalability, or business metrics. - Innovation & Applied Research - Research and evaluate emerging AI technologies, foundation models, and agentic systems to identify opportunities for new products and capabilities. - Design and implement novel machine learning and optimization methodologies tailored to complex healthcare data and workflows. - Drive experimentation and rapid prototyping to accelerate innovation and product development. - Product & Business Impact - Partner with Product, Engineering, and business stakeholders to translate AI capabilities into scalable solutions. - Identify opportunities to leverage Claritev’s data assets to create new AI-driven products, insights, and automation capabilities. - Collaborate directly with clients to gather feedback and ensure solutions deliver measurable value. - Engineering & Production Excellence - Write high-quality, scalable, and production-ready code. - Work closely with Engineering and DevOps teams to deploy and maintain models in production systems. - Develop monitoring frameworks to ensure model performance, reliability, and data quality over time. - Collaboration - Collaborate cross-functionally with Product Managers, Engineers, Data Scientists, and domain experts. - Contribute to team knowledge sharing, code reviews, and best practices. - Provide guidance and informal mentorship to junior team members where appropriate. - Governance & Compliance - Follow best practices for data privacy, security, and compliance (e.g., HIPAA). - Support model validation, monitoring, and responsible AI practices. Qualifications - Ph.D. or M.S. in Computer Science, Statistics, Applied Mathematics, Data Science, or a related field. - 3–6 years of experience post-MS, or 0–3 years post-PhD applying Machine Learning (ML), Predictive Modeling, or Generative/Agentic AI in industry, with a proven track record of delivering solutions from prototype to production. - 1-2 years of hands-on experience with Generative AI and agent development. - Healthcare or health services experience is a plus. - Strong proficiency in Python, deep learning frameworks (e.g., PyTorch, TensorFlow), and agentic frameworks (e.g. LangChain, LangGraph, Autogen, crewAI, n8n). - Expertise in designing and implementing RAG pipelines, and integrating planning, memory, tools, MCP, and A2A protocol for agent workflows. - Experience in building evaluation pipelines for LLM and agent performance, including metrics such as accuracy, reliability, and latency. - Proficiency in using AI Coding tools like Github Copilot, OpenAI Codex etc. - Strong foundation in ML theory, including deep learning, statistics, or optimization. - A product-oriented mindset, with the ability to align applied science work with business objectives and impact. - Excellent communication and cross-functional collaboration skills. Requirements - Specific compensation offers are determined based on a variety of factors including the candidate’s education, experience, skills, work location, and internal equity considerations. - This position is eligible for an annual performance bonus and a comprehensive benefits package, including health insurance and a 401(k) retirement plan. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year. EEO Statement Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. Application Deadline We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
Pharmacy Implementation Consultant
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description Serve as Pharmacy Implementation Consultant Subject Matter Expert responsible for maintenance and management of Oracle Health Millennium pharmacy solutions. This role ensures pharmacy systems are running optimally and support user workflows. Responsibility includes monitoring of application health, implementation of change requests, and overall support for pharmacy systems. - Understand and articulate product functionality and related workflows. - Collaborate with customers and other project teams to define product design and configuration following industry best practices. - Identify and determine inputs and work tasks needed to complete fully functional product configurations. - Lead meetings and sessions with clients and other project team members to complete work tasks. - Perform tasks that need independent judgment to implement EHR products and technology to meet customer needs. - Operate independently without assistance or guidance to provide quality work products to a project team or customer that comply with best practices. - Make recommendations to customers about efficient and effective use of technology. - Mitigate risks and issues. - Act as a mentor and coach to other consultants and team members. - Influence customer roadmap and design. - Contribute to long-term planning and innovation. Qualifications - Minimum of 5 years combined related work experience, including: - At least 3 years of experience in healthcare information technology (HCIT) consulting or other client-facing IT roles. - An additional 2 years of work experience directly related to the duties of the job. - Bachelor's Degree required. - Knowledge and experience with Oracle Health pharmacy applications: Medication Manager, Product Manager, Bedrock, Olympus, PHADBTools, etc. - Experience in HCIT system design and build. - Experience in workflow and technology assessment. - Experience with troubleshooting tools and processes. - Ability to manage work and lead teams. - Strong presentation skills and ability to communicate complex information to operations, financial, and application teams. - Travel up to 50% will be required for this role. Requirements - The salary range for this position is $70-85K. Specific offers take into account a candidate’s education, experience, and skills, as well as the candidate’s work location and internal equity. - This position is also eligible for health insurance, 401k, and bonus opportunity. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. Company Description At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Data Analyst/ETL Developer
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description The Data Analyst/ETL Developer plays a crucial role in providing insights for decision making. The Data Analyst transforms data into usable metrics through data processing software and business development strategies to provide valuable insights to company stakeholders. Job Roles and Responsibilities - Utilize SQL, and/or Python in data analytics to collect, understand, transform, cleanse, store, and share data in a privacy-preserving way. - Debug mappings and identify errors and error rows so that they can be corrected and re-loaded into a target system. - Review and analyze functional requirements and mapping documents. - Develop, maintain, and support ETL data pipelines for healthcare products and analytics platforms. - Initialize and configure data sites/environments to enable downstream analytics and reporting by partner teams. - Collaborate with upstream and downstream teams to ensure successful site onboarding, handoff, and readiness. - Monitor ETL jobs and pipelines in production, identifying failures, performance degradation, and data anomalies. - Troubleshoot and resolve production issues in ETL workflows, including failed loads, data mismatches, and processing delays. - Perform root cause analysis for pipeline incidents and implement corrective and preventive fixes. - Validate incoming healthcare datasets prior to release for downstream consumption. - Build and maintain data validations to ensure: - source to target reconciliation - row counts and completeness - business rule enforcement - data type, format, and constraint integrity Qualifications - Bachelor's degree in Computer Science, Data Analytics, Information Technology, Finance, or a related field. - 6 months to 1 year of experience with SQL and data analytics. - Proficiency in SQL for data manipulation, extraction, and analysis. - Strong analytical and problem-solving skills with the ability to interpret complex data sets. - A proactive problem solver with a keen attention to detail. - Familiarity with agile development methodologies and a collaborative mindset. - Excellent communication skills to effectively translate technical concepts to non-technical stakeholders. Requirements - The salary range for this position is $80-90k. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. EEO Statement Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. Application Deadline We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
Regional Vice President, Business Development, Payer - New Logo
ClaritevAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
Role Description This role is responsible for establishing, developing and expanding our health benefit brokers, healthcare providers, employers, regional health plans, third-party administrator and/or payor relationships. The incumbent will develop sales strategies with a focus on net new business sales. Job Roles and Responsibilities - Establishes, develops and expands Payer, Commercial Health Plans, Regional Health Plans, Blues health Plans, & Medicare Advantage Plans. - Grows one's client base in a continuous manner. - Creates opportunities to come together and unite with Brokers, Stop Loss Carriers and TPAs. - Brings about and nurtures all related marketplace relationships. - Answers client questions about services, contracts while addressing any other concerns that arise. - Meets or exceeds sales goals established on a quarterly basis. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensures compliance with HIPAA regulations and requirements. - Demonstrates Company's Core Competencies and values held within. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Qualifications - Bachelor degree (BA/BS) from an accredited college or university preferred or equivalent experience and discipline. - At least ten (10) years of business development. - Five (5)+ years of experience in employee benefit sales or equivalent disciplines. - Proven and demonstrated successful sales track record. - Experience in dealing with health benefits brokers, third party administrators and regional health plans. - Possesses exceptional multi-tasking ability. - Strong communication skills, both oral and written. - A high level of professionalism, organization and flexibility. - Advanced sales and negotiation skills. - Recognizes and maintains confidentiality of information as appropriate. - Working knowledge and experience using Salesforce. - Self-Motivating personality and a professional demeanor that promotes a team environment. - Willingness to travel, up to 75%. - Ongoing local-area market knowledge. - Ability to bring about and nurture marketplace relationships. - Able to work comfortably in a fast-paced environment. - PC literate, including Microsoft Office products and web-based applications. - Required licensures, professional certifications, and/or Board certifications as applicable. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. - Regular, timely attendance. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. - The salary range for this position is $132K - $180K. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
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