• Manage real time insurance claims while providing customer service to clients • Analyze and approve claims that need to be adjudicated • Determine coverage and apply medical necessity guidelines • Identify and clarify any discrepancies to complete the adjudication process • Work in cohesion with the CIC Department, Prior Authorization, and Billing Departments • Submit claims and add appropriate corrections • Ensure accurate and timely processing of real time claims • Work directly with third party payers for claim resolution • Communicate with facilities on claim issues that will need attention by the facility • Resolve any discrepancies and secure proper reimbursement • Any other duties associated with adjudication • Create Prior Authorizations and notify Authorization team • Follow federal and state regulations • Adhere to company policies and procedures • Follow HIPPA guidelines and regulations

Requisition Number: 2349505 Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS-Optum, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. CPS Solutions-OptumRx is seeking a highly motivated pharmacy liaison (full time, non-exempt) who wants to elevate their practice and be a part of an integrated care team. You will be a part of CPS' Advance Team - our frontline responsible for helping implement customers' specialty pharmacy programs. The Advance Team is expected to prepare new customers for a successful program launch and enable those customers to deliver outstanding clinical and operational results within a short period of time. This Team will help recruit and train the permanent staff for each customer program, ensure a smooth customer onboarding experience, and engage with hospital leadership and staff on behalf of CPS-Optum. This position works at least 40 hours per week, primarily Monday through Friday, and requires travel away from home location for varying lengths of time up to 75%. Candidates must possess a valid driver's license and meet the requirements of a motor vehicle record (MVR) check. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Educating customer's leadership and clinic staff on the CPS-Optum model, to gain their support - Re-designing workflows to help the customer deliver the CPS-Optum experience to patients - Initializing work in CPS-Optum launch clinics and ensuring that the patient/CPS engagement is appropriate and consistent with customer preferences. This includes: - Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival - Explaining the benefits of the customer's specialty pharmacy, without impeding patient choice of pharmacy, and achieving patient participation - Successfully enrolling patients into the program - Performing all benefits investigation, prior authorization, and financial assistance work needed to ensure patients have access to the medication they need - Overseeing services provided to enrolled patients - ensuring that everything from order entry to final verification is completed quickly, accurately, and in accordance with patient's needs - Providing direct support to enrolled patients to ensure that they are supported throughout their therapy regimen and achieve their intended outcome - Appropriately triaging any clinical questions to an appropriate clinician (pharmacist, nurse, or provider) - Assisting the site General Manager with recruitment and training of permanent on-site liaisons - Training client staff liaisons to ensure the CPS-Optum model is followed consistently and each liaison is trained in the same way - Demonstrated ability to work effectively in fast-paced, evolving environments with minimal pre-defined processes, while contributing to the development of future operational standards - Demonstrated ability to adapt to customer-specific preferences and workflows while maintaining compliance with CPS-Optum standards You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High school diploma or equivalent - Pharmacy Technician license, active and in good standing (in home state) - Valid driver's license Preferred Qualifications: - Certification through the PTCB, active and in good standing - or willing to become certified/licensed - Experience working with physicians, nurses, and other healthcare professionals (preferably in a medical clinic) - Specialty pharmacy experience (preferably in a hospital setting) - Proficiency in standard workplace software (e.g., MS Office), EMR systems (e.g., EPIC, Cerner, or Meditech), and dispensing systems (e.g., QS1, RX30, or Computer Rx) - Knowledge of benefits investigation, prior authorization support, and patient financial assistance work Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

• Ensure continuous coverage for PipelineRx clients and support pharmacists by managing order flow • Triage and manage high‑volume client calls • Provide basic technical support and coordinate with IT for advanced issues • Contact healthcare professionals to gather clinical or demographic information needed • Support workflow during downtime and help secure emergency shift coverage • Submit nightly shift reports

Dandy is transforming the massive and antiquated dental industry—an industry worth over $400B. Backed by some of the world’s leading venture capital firms, we’re on an ambitious mission to simplify and modernize every function of the dental practice through technology. As we expand our reach globally, Dandy is building the operating system for dental offices around the world—empowering clinicians and their teams with technology, innovation, and world-class support to achieve more for their practices, their people, and their patients. About the Role Dandy is hiring a Clinical Support Team Lead (CSL) to join our Customer Experience (CX) Operations team, delivering a best-in-class experience to our dental practice clients. In this role, you will lead a team that handles complex dental inquiries through live chat, phone calls, and other communication channels. You will work alongside a small team of peers to oversee daily operations, ensure high-quality interactions, manage escalations, and improve the efficiency of support processes. You’ll own key performance indicators (KPIs) and collaborate with cross-functional teams to foster continuous education for your team. The ideal candidate is a data-driven leader with a keen eye for operational efficiency, and a solid background in customer service. What You'll Do - Supervise and coach a team of front line associates focused on assisting customers with our dental products, services and tools; guiding best practices to achieve the best outcome for their patients. - Responsible for overall team performance and KPIs: - Manage team of CX reps; coaching and providing customer service guidance - Understand, track and report on KPIs including productivity, accessibility and quality. - Uphold performance standards and deliver feedback in 1:1s - Work with the QA team to audit and deliver actionable agent feedback, identifying gaps in process and building out SOPs to close identified gaps. - Identify operational bottlenecks, propose scalable solutions, and collaborate with cross-functional teams to implement improvements. - Develop, maintain, and optimize Standard Operating Procedures (SOPs) to ensure consistency, efficiency, and scalability. - When faced with problems, you use non-standard approaches and root cause analysis to independently resolve issues. - Demonstrates an understanding of data and uses analysis to positively impact your area of ownership. - Foster a positive, collaborative team environment that prioritizes customer experiences and operational excellence. What We're Looking For - 2+ years of frontline leadership experience in customer service, ideally in a startup or tech company. - 1+ years of direct people management or supervisory experience as a title manager is required. - Proven ability to manage and develop a team, driving measurable performance improvements. - Customer service experience required, with proven ability to adapt and empathize with customers to de-escalate situations and offer solutions. - Basic understanding of tech platforms and the ability to learn new platforms quickly. Prior experience with Zendesk is preferred. - Comfort operating in ambiguous, high-velocity environments with a proactive and resourceful approach. - Willingness to roll up your sleeves and fix problems in a hands-on manner. - Intellectual curiosity and a data-driven mindset, with the ability to analyze performance metrics and implement improvements. Bonus Points For: - Previous experience in a healthcare or clinical setting. - Familiarity with the dental industry or prior experience in dentistry. - A positive attitude, sense of humor, and ability to foster a fun and engaging team culture. Job ID: J-1157 For full-time positions, Dandy offers a wide range of best-in-class, comprehensive, and inclusive benefits tailored to each country where we operate. Our local benefits packages typically include healthcare, dental, mental health support, parental planning resources, retirement savings options, and generous paid time off—ensuring our team members are supported no matter where they live and work. Dandy is proud to be an equal-opportunity employer. We are committed to building a diverse and inclusive culture that celebrates authenticity to win as one. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, disability, protected veteran status, citizenship or immigration status, or any other legally protected characteristics. Dandy also fully complies with the Americans with Disabilities Act (ADA). We are dedicated to embracing challenges and creating an accessible, inclusive workplace for all individuals. If you require any accommodations for your interview or have any questions beforehand, rest assured that we will do everything we can to meet your needs. Visit Dandy Careers for more! Data Privacy Notice: By submitting your application, you consent to Dandy collecting, storing, and processing your personal information for recruitment purposes in accordance with our Privacy Policy and GDPR regulations. You have the right to access, rectify, or request the deletion of your data at any time by contacting Privacy Requests.