• Responsible for providing expertise or general support to teams in reviewing, researching and investigating, negotiating and resolving all types of appeals and grievances. • Communicates with appropriate internal parties regarding appeals and grievance issues, implications, and decisions. • May also need to analyze and identify trends for all appeals and grievances. • May research and resolve written complex or multi-issue provider complaints submitted by physicians/providers. • Extensive work experience within own function. • Work is frequently completed without established procedures. • Works independently. • May act as a resource for others. • May coordinate others' activities.

• Accountable for identifying, shaping and delivering strategic results through multiple business analytics disciplines. • Works in collaboration with business leaders to provide thought partnership and drive decision making based on data and analytical insights across different parts of the organization. • Reporting to the head of the Client and Customer Experience (C&CE) Strategy and Analytics team, responsible for providing strategy and analytics support for the operation. • Lead multiple Strategy and Analytics teams within the C&CE organization, working closely with Operations partners to understand business problems at hand. • Develop business cases, secure funding for prioritized strategic initiatives and coordinate strategic efforts with broader enterprise business partners. • Influence new technology solutions that improve the customer experience and generate efficiencies. • Act as a key thought partner for the executives they support. • Directly manage Director and Senior Manager led teams with responsibility for providing thought leadership on work products. • Create compelling business cases and recommendations that influence outcomes with senior executives.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Stewardship Program Lead serves as the bridge between complex clinical policy and our potential member base. You will own the resolution of high-priority escalations regarding medication coverage, GLP-1 stewardship, and clinical eligibility. - Own the Outcome: Serve as the primary point of contact for complex member escalations, untangling issues related to prior authorizations, benefit changes, and eligibility requirements. - Navigate the Complex: Interpret intricate clinical protocols and insurance benefits, translating "insurance speak" into clear, actionable, and empathetic guidance for members. - Master the "Difficult" Conversation: Engage with frustrated or skeptical members who may be mandated to join the program, turning high-tension moments into opportunities for education and partnership. - Operational Excellence: Partner with Clinical Operations and external partners to identify "friction points" in the member journey, helping to build processes to prevent future issues. - Advocate & Educate: Shift the member’s perspective from "compliance" to "impact," helping members see the value of the Twin program. - Specialize in member retention efforts, partnering with cross-functional teams to identify engagement barriers and implement targeted strategies. - Other duties as assigned. Qualifications - Passion for improving the health and lives of our members. - 3-5 years of experience in Care Coordination, Patient Advocacy, Pharmacy Benefit Management (PBM), or Clinical Operations. - Proven track record of managing high-volume, high-complexity member escalations. - Deep familiarity with Prior Authorization (PA) processes and clinical eligibility criteria (experience with GLP-1s is a major plus). - Exceptional verbal and written communication skills - you can simplify the complex on the fly. - Highly adaptable and nimble, able to switch seamlessly between answering calls and working on independent projects with minimal supervision. - Proven track record of remaining calm, flexible, and solution-oriented in high-stress situations and de-escalating complex member interactions. - Moderate to advanced technical proficiency across multiple platforms (Salesforce and Zendesk experience preferred). - Strong organizational skills with the ability to manage competing priorities and maintain accuracy. - High school diploma or equivalent required; Associate's degree preferred. - Availability to work 9am-5pm PST. - Startup experience is a plus. Requirements - This remote opportunity is available to US-based candidates. - Applicants must be authorized to work for any employer in the U.S. - We are unable to sponsor or take over sponsorship of an employment Visa at this time. Compensation and Benefits - The compensation for this position is $70,000 annually. - A competitive compensation package in line with leading technology companies. - A remote and accomplished global team. - Opportunity for equity participation. - Unlimited vacation with manager approval. - 16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents. - 100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options. - 401k retirement savings plan.

• The Sales Support Specialist - Sprouts Teams works with Account Managers, while executing business strategies. • Maintain a great relationship with our Manufacturers, Sprouts team members, Account Managers, and co-workers. • Managing contract entry, coordinating new item submissions, handling order and deduction issues, processing price changes, and assisting with trade planning systems. • Supports and represents the Key Account Managers. • Coordinates key business strategies for each of their Manufacturers. • Provides excellent customer service: Returns e-mails promptly, escalates issues immediately to the correct person, communicates with the Key Account Manager on Manufacturer needs and coordination. • Takes initiative to achieve results. • Identifies when issues need to be escalated to the Key Account Manager. • Assists Key Account Manager in preparing for sales meetings, customer appointments and manufacturer meetings. • Verifies correct cost with manufacturer, submits all price change forms to Sprouts.