Role Description Reporting to the Manager of Pharmacy Operations, the Pharmacy Operations Specialist is primarily responsible for supporting the pharmacy utilization management programs, processing prior authorization requests, and providing pharmacy-related customer service to internal and external parties. In addition, the Operations Specialist will support the day-to-day operations of the pharmacy program as needed. Key Functions/Responsibilities - Receive, process, and review all prior authorization requests received through fax, phone, or electronic prior authorization systems in accordance with all regulatory and accreditation requirements. - Properly apply clinical policy criteria to the review of prior authorization requests. - Review and interpret member’s eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and external clients via telephone or email. - Interprets medical and pharmacy data and accurately enters information into system according to regulatory and NCQA accreditation requirements. - Communicate determinations to members and providers via incoming and outgoing telephone calls, fax notifications, and letter notifications. - Responsible for analysis and issue resolution as it pertains to the administration of the formulary and benefits. - Provide pharmacy-related customer service to both internal and external parties. - Process pharmacy authorizations utilizing PBM real time online claims adjudication software. - Support new clinical program implementation. - Serve as a liaison to Member Services and other internal clients for real-time support on pharmacy benefit interpretation, Pharmacy Policy interpretation, and plan design interpretation. - Other responsibilities as needed. Qualifications - Minimum of a High School diploma or equivalent required. - Associate or Bachelor’s degree preferred. - Two or more years of experience in a professional or pharmacy setting. - Previous experience in a managed care environment preferred. - Prior customer service experience preferred. - Excellent Customer Service skills. - Prior experience assisting members and/or providers with telephone inquiries. - Strong organizational, problem solving, communication, and interpersonal skills. - Excellent written and oral communication skills required. - Must have strong data entry and attention to detail in building cases. - Must be able to multitask and be results oriented. Compensation Range $20.19 - $28.37. This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. Note This range is based on Boston-area data, and is subject to modification based on geographic location. Company Description WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Role Description Você será a primeira referência tributária da Zippi, responsável por estruturar e conduzir a governança fiscal da empresa em um momento de crescimento e transformação regulatória. - Gestão das Obrigações Acessórias: - Assumir a gestão operacional de todas as obrigações federais, garantindo entregas precisas e dentro dos prazos regulatórios. Isso inclui SPED Fiscal, SPED Contribuições, ECF, ECD, DCTF, DCTF-Web, EFD-Reinf e DES-IF. - Reforma Tributária: - Liderar a preparação da Zippi para os impactos da Reforma Tributária nas obrigações acessórias, com foco em DeRE e Split Payment, mapeando o que muda, definindo processos e garantindo conformidade desde o início. - Estruturação e Governança Fiscal: - Mapear gaps, definir o sistema fiscal a ser utilizado, participar da sua implementação e construir rotinas e processos que escalam com o crescimento da empresa. Qualifications - Domínio de obrigações acessórias federais: SPED Fiscal, SPED Contribuições, ECF, ECD, DCTF, DCTF-Web, EFD-Reinf e DES-IF; - Conhecimento de obrigações BACEN (CADOCs, plano de contas COSIF); - Conhecimento sobre os impactos da Reforma Tributária nas obrigações acessórias, com foco em DeRE e Split Payment; - Formação em Contabilidade; - Mínimo de 6 anos de experiência na área fiscal; - Experiência em empresa regulada pelo BACEN. Benefits - Remuneração na faixa alta de mercado; - Learning Budget anual; - Plano de Saúde 100% pago pela Zippi para você e para dependentes até 18 anos. Para cônjuges e companheiros(as), cobrimos 50% da mensalidade; - Auxílio-creche para crianças até 6 anos; - Vale-refeição no Caju; - Férias flexíveis; - Wellhub e Zenklub; - Trabalho 100% remoto.

Role Description We are seeking a Dutch Speaking Operations Customer Expert to join our team. As a Dutch Operations Customer Expert, you will play a crucial role in ensuring the seamless customer satisfaction for our client in the Online retail Industry. - Handle inbound calls and written inquiries from customers - Provide clear, friendly, and professional support in Dutch - Update and maintain customer data - Work closely with your team to deliver the best customer experience Qualifications - Dutch language skills B2-C1 (spoken & written required) - English or Georgian language proficiency - Strong customer orientation and communication skills - Ability to interact confidently with diverse customer types - Good computer skills + fast typing - Creative, solution-oriented mindset and a strong team player - Willingness to work in shifts, weekends, and public holidays - Experience in a similar role is a plus, but not required Requirements - Compensation UP TO GROSS GEL: - Competitive salary - Performance bonus - Christmas bonus - 2000 GEL sign-on bonus - 2000 GEL referral bonus - 650 GEL Life Event Bonus - Other bonus schemes - Paid Health insurance for you and your family - Paid Training - Fast career growth – promotion to Senior level possible after 6 months - Remote work – presence in Georgia required - Wellbeing offerings: yoga, pilates, events, and more - Psychological support: confidential on-site consultations with professional psychologists - Corporate benefits with partner companies - Late shift transportation Benefits - Sign-on bonus of 2000 GEL - Referral bonus of 2000 GEL - Life Event Bonus of 650 GEL - Paid Health insurance for you and your family - Paid Training - Fast career growth – promotion to Senior level possible after 6 months - Wellbeing offerings: yoga, pilates, events, and more - Psychological support: confidential on-site consultations with professional psychologists - Corporate benefits with partner companies - Late shift transportation

Role Description Remote, full-time operational support role focused on: - Supporting Project Management and Construction teams - Functions similarly to a Project Engineer or Contract Administrator - Subcontractor coordination, project documentation, milestone tracking, compliance verification, and construction communications Key Responsibilities - Subcontractor Management - Research and qualify specialty subcontractors - Coordinate site walks, scheduling, and mobilization - Track subcontractor quotes and maintain pricing records - Support subcontractor onboarding (agreements, W9s, COIs, documentation) - Verify insurance compliance before mobilization - Follow up on subcontractor action items - Project Administration - Generate, issue, and track work orders and submittals - Maintain digital project folders and version control - Prepare project handover and closeout packages - Coordinate project photo shoots and documentation deliverables - Track milestone billing requirements - Maintain subcontractor performance and pricing databases - Construction Communications - Support weekly reporting and project updates - Coordinate field communication and look-ahead planning - Capture meeting notes and action items - Ensure project documentation supports milestone billing and invoicing Qualifications - 4+ years of experience in fully remote administrative or operational support roles - 2+ years of experience in construction administration, project coordination, project engineering, or contract administration - Experience supporting both office-based project teams and field construction teams - Strong project tracking and documentation management experience - Experience with subcontractor coordination and compliance tracking - Excellent organizational and follow-through skills - Ability to manage competing priorities and deadlines - Strong written and verbal English communication skills - Proficiency with Google Workspace and Microsoft Excel - Experience using project management/construction software such as Procore, Buildertrend, JobTread, Asana, or similar Preferred Qualifications - Contract Administrator or Project Engineer experience - Commercial interiors project support experience - Experience reviewing subcontractor quotes and side-by-side comparisons - Familiarity with COI management and insurance compliance - Experience with Bluebeam - Familiarity with photo documentation workflows Benefits - Work with an established Design-Build firm with a strong project pipeline - Growth opportunities within a scaling operation - Collaborate with experienced project managers and construction professionals - Join a company with a 35+ year proven industry reputation