Stellus Rx

• Develop comprehensive strategies to optimize relationships with payors, including negotiating contracts, rates, and terms. • Monitor industry trends, regulatory changes, and competitor activities to inform payor negotiation strategies. • Collaborate with senior leadership to align payor strategies with organizational goals and objectives. • Lead negotiations with payors to secure favorable contract terms, reimbursement rates, and payment methodologies. • Evaluate proposed contracts and amendments to ensure alignment with organizational priorities and financial targets. • Manage contract compliance, including monitoring performance metrics, resolving disputes, and implementing corrective actions when necessary. • Oversee the credentialing and enrollment process for healthcare providers, ensuring timely and accurate submissions to payors. • Maintain up-to-date knowledge of credentialing requirements, regulations, and accreditation standards. • Coordinate with internal departments (e.g., provider relations, revenue cycle) to streamline credentialing workflows and minimize delays. • Collaborate with revenue cycle management teams to identify opportunities for improving billing processes, claims submission, and reimbursement efficiency. • Analyze revenue cycle data and performance metrics to identify trends, root causes of denials, and opportunities for revenue enhancement. • Implement best practices and process improvements to optimize revenue cycle performance and reduce revenue leakage. • Cultivate and maintain strong relationships with key stakeholders at payor organizations, including executives, contracting representatives, and network managers. • Serve as the primary point of contact for payors regarding contract negotiations, issue resolution, and strategic initiatives. • Advocate for the organization's interests while fostering collaborative partnerships with payors to achieve mutual goals.

• Assess, design, implement, automate, and document core business solutions and processes for public and private cloud environments. • Work with diverse technical and business partners to define, research, select, implement, and optimize business solutions within the Stellus Rx Enterprise Architecture. • Apply strong and demonstrable knowledge of data science, machine learning, and neuro-symbolic AI design to architect solutions. • Champion AI capabilities internally to advocate for and implement AI-driven solutions. • Identify and implement unused or new vendor/partner features that improve return on system investment; use AI to surface adoption opportunities. • Use AI to continuously monitor solution performance and drive data-informed optimization decisions.

• Design, implement, and maintain AWS infrastructure with a strong focus on Infrastructure as Code (IaC). • Use AI-assisted tools to continuously improve automation scripts and operational procedures. • Develop and maintain CI/CD pipelines for automated testing, build, and deployment processes. • Use AI-enhanced monitoring and observability platforms to proactively detect performance degradation, cost anomalies, and infrastructure drift. • Troubleshoot issues related to AWS infrastructure and application deployments using AI-assisted root cause analysis. • Implement environmental security processes and compliance auditing using AI-enhanced tooling. • Identify, correct, and enhance software tools and systems operations with a focus on automation and cost minimization. • Collaborate with product owners, developers, and support staff to ensure continuous and reliable delivery of service.

• Develop, construct, and maintain large-scale data processing systems that collect data from a variety of structured and unstructured sources. • Build and optimize ELT pipelines using AI-assisted tooling to identify bottlenecks, suggest optimizations, and automate routine pipeline maintenance tasks. • Identify, design, and implement internal process improvements: use AI to automate manual processes, optimize data delivery, and re-design infrastructure for greater scalability. • Build the infrastructure required for optimal extraction, transformation, and loading of data from various sources. • Prepare data for data scientist exploration and discovery using AI-assisted data profiling and quality assessment tools. • Perform data wrangling and munging for downstream analytics and machine learning. • Enable large-scale machine learning by designing and maintaining annotated datasets, elastic search approaches, and scalable data lake structures that support AI/ML workloads. • Create and maintain analytics pipelines that generate data and insight to power business decision-making. • Collaborate with data scientists, analysts, and business stakeholders on requirements for dimensional modeling and ETL pipelines. • Develop and maintain data quality frameworks; use AI to automate anomaly detection, schema validation, and data contract enforcement across pipelines.

• Use AI-assisted tools to write, review, and optimize shell scripts • Leverage AI to accelerate system audits and generate configuration documentation • Apply AI-powered monitoring and alerting tools • Ensure uptime, performance, security, and resource efficiency of servers • Install, configure, and maintain system updates, patches, and upgrades • Monitor and tune systems • Configure and manage data storage solutions • Evaluate and resolve issues related to patches and system applications • Use AI tools to rapidly diagnose system and application issues • Implement and maintain system security policies

• Use AI tools to generate, review, and optimize automated test cases. • Leverage AI-assisted analysis to understand code flow and component interactions. • Build and maintain automation test suites across Mobile, Desktop, and Web platforms. • Apply AI tools to identify gaps in existing test coverage and prioritize high-risk areas. • Investigate user problems using AI-powered analysis and create bug reports. • Integrate automated test suites into CI/CD pipelines and monitor test results. • Develop and maintain status reporting and dashboards on testing activities. • Participate in backlog refinement and design test cases. • Collaborate with deployment teams to resolve issues and improve testability. • Research test tools, methodologies, and AI-driven QA trends.

• Assists team members by providing support, identifying adherence barriers, improving adherence, and facilitating team success and growth. • Leads the Adhere Technician team to provide support, identifying adherence barriers, improving adherence, and accurately facilitating patient compliance. • Understands and maintains confidentiality with respect to patient/client care; complies with all federal and state laws applicable to confidentiality of protected health information (PHI) and electronic protected health information (ePHI); follows HIPAA guidelines. • Adheres to and helps communicate all departmental and company policies to team members as needed. • Leads and supports daily technician operations. • Mentors, trains, and supports fellow team members to ensure strong performance and continuous development. • Manages direct reports, facilitating their professional growth, providing ongoing coaching, and supporting career development. • Conducts formal 1:1 meetings with direct reports to review performance, set goals, and document progress. • Oversees and approves direct reports’ timecards, ensuring accuracy, compliance, and timely submission. • Collaborates cross‑functionally to improve workflows and drive operational efficiency. • Serves as a point of contact for escalations and quality assurance. • Reviews patient profiles to identify potential medication-related issues and discrepancies. • Collects and analyzes medication-related data to identify trends and opportunities for improvement. • Generates and analyzes reports on medication adherence, patient outcomes, and other relevant team metrics. • Assists the Adhere Quality Team with onboarding, training, and other quality-related tasks as needed. • Promotes teamwork, professional services, and clear communication. • Performs other related duties as assigned.

• Use AI coding tools as a primary part of your development workflow. • Ensure accuracy of architecture through analysis and thorough problem resolution. • Build web and mobile applications with a mindset of leveraging AI. • Work in a DevOps environment with understanding of CI/CD pipelines. • Interface with NoSQL and relational databases; design and optimize data access patterns. • Communicate effectively with scrum teams and Product Owners. • Develop and maintain web service integrations across a modern AWS cloud stack.

• Use AI-enhanced SIEM, XDR, and threat intelligence platforms to continuously monitor security events across cloud and on-premises environments. • Analyze security alerts, logs, and threat data using AI-assisted tools to rapidly distinguish true positives from noise. • Proactively hunt for threats and anomalies using AI-informed behavioral analytics. • Lead and support security incident response activities; use AI tools to accelerate root cause analysis. • Conduct and support vulnerability assessments across cloud, application, and infrastructure environments; use AI tools to prioritize remediation efforts. • Support compliance activities across relevant frameworks (e.g., HIPAA, SOC 2, NIST); use AI tools to monitor for policy drift.

• Designing, implementing, and overseeing pharmaceutical programs within a population health management framework. • Collaborating with healthcare teams, analyzing population health data, and developing strategies to optimize medication usage. • Creating educational materials and initiatives to enhance patient understanding of medication usage. • Ensuring compliance with regulatory standards related to pharmaceutical services. • Providing leadership to the pharmacy team and establishing key performance indicators (KPIs).